Andrew’s Blog

Insights into Bike Myths and Truths (part 3) Posted on June 10, 2017, 0 Comments

As far as strength, the strength required to pedal a bicycle at 300 watts and 90rpms is about the same force that is required to stand up from a chair. It's close to a 45lb single leg press. Something the vast majority of humans can easily accomplish one time without taxing the ability to produce force very much at all. In other words, we are not talking about all that much force, and hardly anyone is anywhere near force or strength limited when riding a bike. What does limit us is the ability to produce that force 90x a minute for multiple minutes or hours. Otherwise known as aerobic capacity.

RESPONSE (a long one BTW) It's like you've read my first book! But just in case, here's a quote:

"Strength, as defined by Bompa in Periodization: Theory and Methodology of Training, is “the neuromuscular capability to overcome an external and internal resistance.” The strength of an athlete is determined by how much work that athlete can perform. In triathlon, then, the competitor must be strong enough to complete the distance. So if you cross the finish line, is this strong enough?

No matter where you placed in your last tri, you covered the same distance as all the other competitors. You got the work done. As a matter of fact, since you all completed the same course, it could be said that you are all equally strong. But that would be inaccurate.

Let’s say that you’re a Clydesdale who always wins his category but just misses out on taking the overall title. So you cherrypick a small Olympic distance race in the middle of nowhere and peak for it like it’s the World Championships. You’ve visualized this race a thousand times and already have a spot picked out for the overall trophy on your wall of fame. You’re gonna rock!

And then I show up.

I live nowhere near the race venue. But I happen to be attending my grandmother’s ninetieth birthday party and hear about this race at the last minute while stopping to use the bathroom at the local Waffle Hut which is sponsoring the event (I wouldn’t eat there!). You see me in the transition area and immediately mark me as possible competition. After all, I have a carbon-fiber Cervelo and the absence of a mullet makes me conspicuous among the rest of the field. But at a buck thirty, I’m not an impressive figure, so you’re not terribly worried as we wade out into the water together.

And then I beat you.

Only by a second or two, but I beat you. You put a minute on me out of the water. Then I catch you on the bike, hammering back to transition to start the run with almost a two-minute advantage. Your long legs eat up most of my lead during the final leg, but, in the end, you run out of real estate and cross the finish a few steps behind me. You’re bummed but console yourself with the knowledge that you made me work for the win, saying you simply lost to a stronger athlete.

How wrong you are.

You weigh two hundred pounds. I weigh 130. We both covered the same distance. But you had to carry an additional seventy pounds over the course of the race. Technically, you did more work. Work is force applied over distance. It is the product of the amount of resistance overcome (two hundred pounds vs. 130 pounds) and the distance over which that resistance is moved (an Olympic distance triathlon). You are the stronger athlete. Strap a seventy-pound weight to my body, and I would probably still be at the bottom of the lake somewhere.

I know, I’m not making much of a case for strength training here. I mean, if it’s not the strongest athlete who wins, why lift weights, right? If you’re thinking like that, I can tell you’ve skipped the first several chapters of this book. There’s a multitude of reasons, but let’s look at strength and its critical role in the performance of a triathlon.

If we change some of the parameters of the imaginary race cited above, it may provide you with a clearer understanding of the importance of strength in our sport. Let’s say I let myself go a bit during the off season—to the tune of seventy pounds. I win a year’s supply of Breyer’s Mint Chocolate Chip and decide I’m going to test out the Ullrich Theory of Performance Enhancement. We both show up on the starting line, but this time I’m two hundred pounds, same as you. You win the race walking away, with a personal best of two hours even. I score a different type of PR—four hours. You probably could’ve lapped me if you’d run the course a second time. Obviously you’re the stronger athlete now, right?

Wrong again.

Once more, we both completed the same distance. Yet now we weigh the same. We both did the same work. It doesn’t matter if I took twice as long as you to cover the distance, as time is a variable which does not enter into the strength equation. Time is important in the equation for power. By the strictest definition of strength, we are both equal despite the fact you had enough time to shower, eat, and overhaul your bottom bracket before I crossed the finish line.

Why then, are we wasting our time on strength development? Why not just skip to power training (no pun intended) if that’s what’s really going to determine who finishes a particular race in first place?

Power is how much work is done per unit of time or, expressed as an equation:

POWER = [FORCE (i.e., strength) x DISTANCE]/TIME

The reason triathletes must first focus on strength is because this biomotor ability is a crucial component in the optimal development of power. Tudor Bompa, in his groundbreaking book Periodization: Theory and Methodology of Training, agrees. Strength development, he says, “should be the prime concern of anyone who attempts to improve an athlete’s performance.” Its importance is again highlighted on a page from Advanced Program Design, which states, “When strength or any of its derivatives are the primary deficit, efforts should focus primarily on its development first.” Thus, to maximize power development, we must either maximize strength or maximize speed, or, with a good training program, maximize both.

Maximum Strength is the highest force that can be performed by the neuromuscular system during a maximum voluntary contraction.

FORCE = MASS x ACCELERATION (F = M x A)

So to increase the force produced, we can increase the resistance (M) or the speed at which the resistance is moved (A). Yet increasing movement speed is not as effective in the development of maximum strength as increasing the weight of the resistance, due primarily to the role momentum plays in the lift.

Momentum is mass in motion. For those of you who fell asleep in physics class, I’ll keep this simple. The more mass or velocity an object has, the more momentum that object will possess. That’s one reason why you see some people swinging their free weights around and rushing through a set of twelve like their lives depend on it. The only newton they’ve ever heard of is a cookie. But they innately know that once they start their hundred-pound bicep curl with their back and knees, their arms can be along for the ride. Momentum is their ego’s best friend.

Maximal tension on a muscle, which is critical for maximal strength development, is only increased during the initial acceleration of the load. After that, momentum takes over and effectively reduces the tensile loading of the muscle. But if you use a sufficiently heavy weight, the speed at which the weight is lifted will be limited. Thus, the contribution of momentum to the lift will be minimized, as well.

This is not to say that you should not try to accelerate the load as quickly as possible. To quote Chek again, “The closer a given load is moved to maximum velocity the greater the intensity and the greater the training effect on a neuromuscular basis.” The neuromuscular benefits to which Chek refers are:

increased neural drive to the muscle
increased synchronization of motor units
increased activation of the contractile apparatus
decreased inhibition of the protective mechanisms of the muscle (Golgi tendon organ).

Basically, you’re making the muscle smarter when you challenge it with a sufficient resistance, literally putting brains behind that brawn. And a smart, functional muscle is a strong muscle.

Strength is, ironically, often an endurance athlete’s biggest weakness. But the intelligent triathlete quickly learns to apply this one golden rule: Train your weaknesses and race your strengths."


Again, I am not really trying to argue with Andrew, because I can't. He knows more about the body than me by orders of magnitude. In the end, we are all after the same thing, results. And that is my battleground. Exercise physiologists, physical therapists and the larger research community have always lagged behind real coaches. Great coaches find performance, and then everyone else figures out how they did it. While not able to hold my own in any body knowledge debate, what I would certainly do is rest my case for simplicity on the performance of my athletes, the results of my bike fits, and my excellent record of not injuring the vast majority of them along the way.

RESPONSE: While admitting I lag behind many people in various areas, I need to clarify I actually have SOME knowledge of coaching/training. In fact, I can honestly say that of the many people who grace my client roster, some are quite accomplished in their various sporting endeavors. For the sake of brevity, I'll focus on the endurance athletes I've worked with--including professional cyclists, national champions both in the US and abroad, winners of both stages and the overall of some UCI level races. Heck, I even recall working with a Grand Tour Winner. I daresay some of them might even go so far as to call me a decent coach/trainer. Does that make me anybody to listen to--nope! What does, perhaps, is having studied and practiced under some of the greatest minds in the fields of human performance and health and then practicing what I preach so I end up being more than just a talking head, academic with no real, practical experience. Even then, I encourage whoever may be listening to not believe anything I've said until they've learned it properly and applied it to themselves. Take the knowledge off the page and do something with it before claiming to know it. And even then, realize there's always more to learn. One of the reasons I've actually enjoyed this exchange with you, Dave. Now, I do qualify for a free bike fit and it would be fun to continue this discussion in person. But I've been fitted by Matt Cole himself. And my riding time is, sadly, limited these days. Guess I'm spending too much time on FB. I'll give you the last word, though (as you can see) I've used most of them. If you've read this far, I applaud you. Your endurance is likely surpassed by few.

Working out 4 days/week vs. 6 days/week--Which is Better? Posted on February 22, 2015, 0 Comments

Question:
Currently I work out six days a week. Five of those days I do 30 minutes of intense cardio (alternating among bike, climber, running, elliptical) preceded or followed by ten or fifteen minutes of strength work (stuff from your book). One of those days I do non-stop 45 minutes of strength work, also from your book. One day I rest.
As you know, my goal is optimal fitness. I have read some articles suggesting that working out four days a week rather than six is better for optimal fitness. 
What is your opinion? 
Answer:
Everyone is different.  I would say that a quality training program needs to be designed around rest.  Rest is more important:
--the older you are
--the more intensely you train
--the longer you go between unloading days (or unloading weeks/months/years)
--the less your background in regards to a specific training protocol
--the more stress to which you are exposed
The better one takes care of their body (via the Six Foundational Factors of Health--http://triumphtraining.com/blogs/blog/6363808-the-six-foundational-factors-of-health), the greater threshold that person will have for any stress, including that which comes from exercise. 
Could 6 days be perfect for you--yes.  But so could 4.  And it likely depends on a host of different variables, so I wouldn't get too attached to any specific periodization scheme.  Instead, I would listen to your body. 

My instincts tell me that you are possibly utilizing intensity more than is optimal.  Variety of intensities would likely serve you better and probably result in harder hard days because you're rested enough to truly push the envelope.  I also would encourage you to add a day of active rest where you benefit from movement but at a level of exertion which keeps you anabolic rather than catabolic--breathing through the nose only, no muscular burn, minimal increase in HR. 

Question from a Triathlete about back pain during the run portion of a 70.3 Race Posted on October 05, 2014, 0 Comments

Question:

I had a question about my recent fit on my Cervelo P3.  I just raced in the Superfrog half ironman in Coronado, CA.  After my bike ride I had pain in my middle back about where my kidneys are located.  It caused me to have breathing issues for the first couple of miles of the run.  It hurt to take deep breathes.  I have been following the exercises and stretching recommended in your recommended book, Holistic Strength Training for Triathletes.   I stayed aero for about 80-90 % of the ride.  I have not had any issues on previous bike rides, but those rides have been with a group and I have only stayed aero for about half the time.   Any suggestions?

 

Answer:

(I happen to know exactly who positioned this athlete on his bike, so I do not question his fit which would typically be the most obvious suspect).  The S.A.I.D. principle is a crucial aspect to consider in the training of any athlete, and I think its importance is highlighted in your case. Lack of aero time coupled with the higher intensity of a race environment is the most plausible scenario--especially if you had no history of previous issues in training and the pain resolved after a few miles of change in position during the run. You likely needs more specific stretching of the psoas (not shown in my book) which targets the fascia. I teach myofascial stretches to any of my clients who are not responding as well as I would like with the prescription of stretches in their programs.  However, the positions used are quite technical, and the psoas is probably one of the most complex.  These muscles originate on the lumbar spine in your area of complaint. They get worked and habitually shortened in cycling, and it's even worse in the aero position. Additionally, the psoas reflex to the adrenals which are highly taxed with endurance exercise.  So addressing the fascial restrictions specific to the psoas can have incredible resultss in both performance and in health.  Also, addressing nutrition and lifestyle (in and outside of training/racing) will give you greater tolerance for the demands of triathlon as well as better performance.  The last section of my book should help you dial in the Six Foundational Factors.  And the more consistently you apply them, the more pronounced the benefits will be. Following the proper development of an athlete is critical, too, of course.  Cycling is an expression of power which cannot be fully realized without adequate proficiency in the areas of flexibility/stability (i.e. core strength).  Thus, until these two areas are sufficiently up to speed, you may have to lessen your race effort or aggressiveness of your cycling position (or both).

Chronic Stress and Physical Performance/Recovery Posted on August 15, 2014, 0 Comments

J Strength Cond Res. 2014 Jul;28(7):2007-17. doi: 10.1519/JSC.0000000000000335.
Chronic psychological stress impairs recovery of muscular function and somatic sensations over a 96-hour period.
Stults-Kolehmainen MA1, Bartholomew JB, Sinha R.
Author information

Abstract
The primary aim of this study was to determine whether chronic mental stress moderates recovery of muscular function and somatic sensations: perceived energy, fatigue, and soreness, in a 4-day period after a bout of strenuous resistance exercise. Undergraduate resistance training students (n = 31; age, 20.26 ± 1.34 years) completed the Perceived Stress Scale and the Undergraduate Stress Questionnaire, a measure of life event stress. At a later visit, they performed an acute heavy-resistance exercise protocol (10 repetition maximum [RM] leg press test plus 6 sets: 80-100% of 10RM). Maximal isometric force (MIF), perceived energy, fatigue, and soreness were assessed in approximately 24-hour intervals after exercise. Recovery data were analyzed with hierarchical linear modeling growth curve analysis. Life event stress significantly moderated linear (p = 0.027) and squared (p = 0.031) recovery of MIF. This relationship held even when the model was adjusted for fitness, workload, and training experience. Perceived energy (p = 0.038), fatigue (p = 0.040), and soreness (p = 0.027) all were moderated by life stress. Mean perceived stress modulated linear and squared recovery of MIF (p < 0.001) and energy (p = 0.004) but not fatigue or soreness. In all analyses, higher stress was associated with worse recovery. Stress, whether assessed as life event stress or perceived stress, moderated the recovery trajectories of muscular function and somatic sensations in a 96-hour period after strenuous resistance exercise. Therefore, under conditions of inordinate stress, individuals may need to be more mindful about observing an appropriate length of recovery.

 

Original study found here: http://www.ncbi.nlm.nih.gov/pubmed/24343323

Question about Strength Training for an Ultra Runner Posted on May 22, 2014, 0 Comments

Question:

1. Which are the best strength exercises to train the quads eccentrically (for the downhills)?
2. In addition to your book, I have also read Tudor Bompa's "Periodization Training for Sports".  He suggests after the Max Strength period a "Conversion to Muscular Endurance" period, lifting 30-40% of 1RM for 4-10 minuets non stop.  I have tried this method and managed to get up to 3 minuntes of continuous lift and end up with burning muscles and tears in my eyes.  What is your opinion on that type of training?

 

Answer:

Thanks for your purchase then--every book I sell is more I can donate to LLS.  So you have the gratitude of many others, too.

1--Try not to think quad so much as leg, even if you feel that these muscles are the limiter during downhill running.  Even then, try not to think leg so much as body.  Thus, proper core activation (strength/timing/balance of uppers vs. lowers, ext vs. intern obliques, etc) will be critical to help dissipate the load throughout the kinetic chain without excessive energy loss secondary to faulty/inefficient movement patterns and compensations.  But an exercise I might recommend would be jumps or exploding harvards or something from the plyometric drill section of my book (one legged versions more sport specific than 2 legged, of course).  What you want to look for is the ability to STAY in one place with minimal lateral or sagittal plane deviations--the better you can do this, the more stable you are (=better force production and alignment/less injury potential).  These movements also more readily replicate the movements speeds encountered in running.  Core recruitment is extremely high, too.  But, obviously, these are expressions of POWER and, thus, built on a foundation of strength, stability, and flexibility.  Lastly, know that as your training volume in-sport increases, your training outside of running will likely need to decrease.  Thus, proceed with caution with the eccentric loads mentioned above.  When in doubt, stretch and train the core.  And even before that, get the nutrition/lifestyle working for rather than against you.  That's what my next book is all about--hope to have it finished after RAAM this year (3 weeks away).
2--I like Bompa and respect his work enough to have referenced him in my book (and other work).  However, I think this kind of training is of limited value in your case.  Yes, it's increasing work capacity.  But you can do that more specifically by utilizing your sport (among other methods).  And when you mix high density training (which is what that is) with high intensity training (which is what this may feel like--but, in truth, it's not) in the same session, neither biomotor ability (endurance and strength or endurance and power or both/all 3) end up developing to the potential they could.  Typically, strength/power are sacrificed along with form--and when movement quality suffers, you're programming your computer with faulty info.  Save the true endurance training for your sport of choice (or cross-training as necessary) and focus on what the limiter is for most endurance athletes--strength/power. 

Hope that helps. 

Phasic vs. Tonic Muscles Posted on May 08, 2014, 4 Comments

To stretch or not to stretch? That is not the question. Not really. Though there are numerous studies debating the merits of stretching, the ones which find no benefit to the athlete are typically flawed. The authors researching the efficacy of stretching inevitably apply a general stretching protocol to the subjects in their study with a one-size-fits-all mentality. But different activities cause different responses in different muscles. This is simple to understand when one considers that not all muscles are created equal. For the purpose of this discussion, I will focus on the difference between Phasic muscles and Tonic muscles.

Phasic Muscles are composed of at least 51% fast-twitch muscle fibers. These are powerful muscles, but they fatigue more easily than do tonic muscles. Kind of a shame, too, as these muscles are primarily responsible for movement. The gluteals are good examples of phasic muscles.

Tonic Muscles are slow-twitch dominant, composed of at least 51% slow-twitch muscle fibers. As such, they are highly resistant to fatigue and have a greater propensity for work. The iliopsoas is an example of a tonic muscle group.

One of the major differences between phasic and tonic muscles that is of particular interest to triathletes is how these muscles respond to faulty loading. Loading is the resistance which the muscles of the body must overcome. In the gym, it may be a dumbbell. In life, it’s gravity. Thus, even if the only weight room you’ve ever spent time in is the wait room at your doctor’s office, it’s fair to say we all experience loading in our lives. Faulty loading can take the form of under-use, misuse, or disuse. But as triathletes, who swim, bike, and run for up to seventeen hours all in the same day, the form of faulty loading we are typically concerned with is overuse.

Tonic muscles respond to faulty loading by shortening and tightening. With a lower threshold for stimulation, tonic muscles need very little encouragement to turn on. This can, and often does, result in hyperactivity of a tonic muscle, limiting the motion at the joint(s) over which that muscle crosses. As mentioned in Chapter One of Holistic Strength Training for Triathlon (http://triumphtraining.com/pages/holistic-strength-training-for-triathlon) , this lack of flexibility (or more specifically, this lack of mobility) results in all the biomotor abilities being adversely affected.

Phasic musculature does the exact opposite. It tends to lengthen and weaken in relation to its relative antagonist(s) or opposing muscle (group). The problem is then magnified by the fact that muscles which are short and tight will hold their antagonists in a lengthened position. This can lead to what is commonly termed stretch weakness. Stretch weakness is defined by Florence Kendall in her book entitled Muscles: Testing and Function with Posture and Pain as

weakness that results from muscles remaining in an elongated condition, however slight, beyond the neutral physiological rest position, but not beyond the normal range of muscle length.

She goes on to say that “the concept relates to the duration of the faulty alignment rather than the severity of it” (italics mine). So is it any surprise that the aspiring triathlete, who may spend up to seven hours at a time hunched over the bike with a rounded back, has increased thoracic kyphosis and can’t stand up straight? Brick that with a swim where the pectorals and medial shoulder rotators get overworked during the course of an hour-and-a-half-pool session, and the source of the typical triathlete’s faulty posture becomes clear. Now the lengthened muscles of the thoracic spine are being pulled by the tight muscles of the chest, shoulders, and lats. This results in even more thoracic kyphosis.

Maybe you should just run, you’re thinking. Well, the increased lumbar curvature created by the tight, overworked quads and hip flexors of the average runner causes a compensation in the thoracic spine leading to… say it with me… increased thoracic kyphosis. So much for the benefits of cross training, right? Instead of one source for our orthopedic and postural aberrations, we triathletes have three. I guess we’re just S.O.L.

But no, we’re not out of luck. We just can’t rely on dumb luck when it comes to our stretching program. We can’t just do random stretches for every part of the body and expect our sport-specific muscle imbalances to be addressed. We need a specific course of stretching which actively targets the muscles we abuse when we swim, bike, and run.

The question then isn’t if to stretch, but when to stretch and how? If you perform stretches for every part of the body, you haven’t done anything to alleviate the muscle imbalance caused by your triathlon training. The tight muscles are still tighter than the loose ones. Your body is still out of alignment. And a body that’s not properly aligned moves and functions less efficiently, increasing its susceptibility to fatigue and, ultimately, to injury.

The bicycle wheel is a common analogy which effectively represents this idea. Ideally, thirty-two spokes running from the rim to the hub are tensioned appropriately to keep the wheel spinning true. Logging a lot of miles on the bike, especially under harsh road conditions with bumps or potholes, can lead to a wheel which wobbles as certain spokes get tighter while others become looser. Each imperfection in the road leads to the wheel wobbling worse and worse.

During college, I worked in a bike shop in St. Petersburg, Florida. Some Mondays, guys would come in with their wheels after crashing at the weekend’s bike race to see if the wheels were salvageable. The head mechanic, a guy named Ray who worked wonders with the spoke wrench, would stick the wheel in the truing stand and spin it. The arms of the stand would tell him which spokes were in need of tightening and which should be loosened. He’d keep fine tuning the calibration of the stand—tightening a spoke half a turn here, loosening another with a quarter turn—until the wheel ran as straight and true as the day the cyclist bought it.

Some wheels, and some cyclists, weren’t so lucky. One day a guy in shredded Lycra limped into the shop carrying his mountain bike. He’d gone down pretty hard on a training ride and his front wheel was so out of true he’d had to walk the bike to the store. The guy asked us if we could fix it enough for him to ride it home. Not much for words, Ray took the wheel from the guy, went behind the counter, and held it up at eye level as if he were reading which spokes needed attention. Suddenly, and with force which could be heard over the Chili Peppers playing on the shop’s stereo, he slammed the wheel down hub-first again and again. After a few seconds, he paused, repositioned the wheel in his hands like a guy making a pizza, and slammed it down on the counter a few more times. Finally, he stopped banging the wheel and gave it back to the cyclist, who looked a bit more abused than when he’d come in. But his face changed as he spun the wheel. It still wobbled. But if he could endure a jerky ride, the wheel looked like it just might get him home.

Throughout the body, ideal length-tension relationships exist which, when altered by chronic shortening or lengthening of certain muscles, result in faulty joint kinematics. It’s a matter of physics. Forces generated by movement or loading cannot be adequately dissipated in a joint which has moved away from its instantaneous axis of rotation. The resulting premature degradation of the joint itself inevitably hastens the demise of the triathlete’s competitive career. But if you stretch the right muscles at the right time and in the right way, just like a wheel in a truing stand, your chances of maintaining your orthopedic integrity increase exponentially. And though I can’t promise you that you won’t ever have to walk your bike home, with correct stretching you should never have to limp your body home.

Twist Pattern Posted on December 21, 2013, 0 Comments

Usually coupled with other movements, twisting is an integral part of most sports, and triathlon is no exception. In fact, rotation is the core of all movement. Swimming is predicated on rotation. If a runner can’t twist, the movements which propel him forward are not only shortened, they are less efficient and the restriction will likely cause a compensation which will result in injury. Even cycling has rotational forces which must be stabilized in the body to deliver optimal power to the pedals. Proficiency in the twist pattern, then, should be a goal of every triathlete who wants to make it, not only to the starting line, but to the finish line as well.

First Descent—Kneeling
Second Descent—Seated on Swiss Ball
Third Descent—Seated on machine

EXAMPLE EXERCISES

T Push Ups
1. In prone position with arms outstretched and hands placed shoulder width apart directly underneath the shoulders, lower the body down until the upper arm is approximately parallel with the floor.
2. Push back toward the start position by extending the arms while simultaneously rotating to the dominant side so that body is supported by the non-dominant arm. Feet should roll on top of each other if proficiency allows. Otherwise, feet can remain apart, giving more stability.
3. Return to start position by reversing the motion and then repeat on the opposite side.

Twister
1. In prone position with arms outstretched, hands placed shoulder width apart directly underneath the shoulders, and shins on top of a physio ball, rotate lower body to one side as far as possible without losing neutral spinal curvatures.
2. Rotate back toward the start position and continue the movement in the opposite direction.
3. Return to start position and repeat for the designated number of reps.

Upper-Body Russian Twists
1. Seated on a physio ball, roll body down until the ball supports the head and shoulders. Feet on the ground with shins perpendicular to the floor. Arms should be outstretched in front of body so that hands are in front of the chest with the fingers interlaced. Maintain TVA function (i.e., navel drawn in slightly) to avoid over-recruitment of the lumbar erectors.
2. Rotate torso to one side by rolling the ball and the shoulder together while keeping the hips elevated. Hands should move because the body moves—i.e. roll, don’t reach).
3. Rotate back to the start position and then repeat the movement in the opposite direction.
4. Repeat for the designated number of reps. Reposition feet as necessary. If head comes off ball, make sure tongue is placed in the physiological rest position so that forward head posture is not exacerbated.

Lower-Body Russian Twists
1. In prone position with arms outstretched, hands placed shoulder width apart directly underneath the shoulders, and shins on top of a physio ball, flex the hips so that the body is in a pike position.
2. Rotate pelvis to one side by rolling the ball and the hips/lower legs together.
3. Rotate back to the start position and then repeat the movement in the opposite direction.
4. Repeat for the designated number of reps. Reposition hips as necessary.

Drop and Recover
1. Seated on a physio ball, roll body down until the ball supports the head and shoulders. Feet are on the ground with shins perpendicular to the floor. One arm should be outstretched in front of the body with the palm facing down. The other arm is retracted into the ball with the hand at the level of the shoulder, palm down.
2. Explosively rotate torso in the direction of the arm that is outstretched in front of the body while simultaneously switching the positions of the arms so that the opposite arm is outstretched in front of the body and the other arm powerfully retracts into the ball. Lower body works in conjunction with the upper body so that the end position is supported by the legs and the elbow of the arm that’s on the ball.
3. Descend back to the start position before immediately rotating explosively up to the other side.
4. Repeat for the designated number of reps.

Twisting Lunge (Walk)
1. Standing with Good Posture, take a step forward with the non-dominant leg so that the shin is perpendicular to the ground when the thigh is at parallel. Simultaneously, twist upper body in the direction of the forward leg. Knee should track over foot throughout the movement. Torso should remain upright and the trailing leg should be bent with the knee almost touching the floor (as flexibility/strength allow) while ball of foot stays in contact with the ground.
2. Pushing through the heel, move forward to a standing position and repeat on the opposite side.


Lunge (Walk) Arc
1. Standing with Good Posture while holding a weight on the side of the dominant leg, take a step forward with the non-dominant leg so that the shin is perpendicular to the ground when the thigh is at parallel. Simultaneously, arc weight over the head from the dominant side to the non-dominant side so that it ends up outside the hip of the forward leg. Knee should track over foot throughout the movement. Torso should remain upright and the trailing leg should be bent with the knee almost touching the floor (as flexibility/strength allow) while ball of foot stays in contact with the ground.
2. Pushing through the heel, move forward to a standing position and repeat on the opposite side.

Bend Pattern Posted on December 08, 2013, 2 Comments

One of the most important of the primal patterns, this movement is one we perform multiple times a day without much thought. It’s probably not on our mind when we’re bent over the bars during the bike leg of a triathlon either. But we stand up and take notice when we realize that strength in this pattern helps us actually to be straight when we stand up! Bending strengthens both the ligamentous system and the muscular system, without which we’ll be running out of T2 folded at the waist. Thus, this movement pattern is critical. If the triathlete can’t bend, he’ll break.

First Descent—Spotter support
Second Descent—From knees
Third Descent—From seated

EXAMPLE EXERCISES

Dead Lift
1. In a Squat position with feet positioned a little wider than hip width apart and externally rotated slightly, grasp a barbell with an alternate grip (supinated on one side and prontated on the other).
2. Inhale to charge the thoracic cavity, draw the navel in toward the spine, then ascend to the standing position by leading pushing through the heels and exhaling through pursed lips after passing the sticking point of the ascent. Ensure knees track over feet throughout the movement and lumbar spine never rounds into kyphosis (which may limit how deep the movement can be peformed).
3. Inhale and draw the navel in again before returning to the start position and repeating the movement with the exception of the inhalation which should now be performed in the standing position.

Bent-Over Row
1. Stand with feet pedal-width apart holding a pair of dumbbells or a bar with a supinated grip, chest out, shoulders back, navel in.
2. Soften the knees (approximately 20° bend), which makes the iliotibial band taut so that the gluteus maximus has a foundation off which to work. The glutes can then help share the load so that the back need not work in isolation.
3. Pivot forward at the hips so that the torso is positioned between 45 and 90° in relation to the legs. The angle should be dictated by the flexibility in the hamstrings—if the back starts to round or you lose your neutral lumbar and thoracic curves, you have bent over too much. Head should remain in neutral, too, (i.e., don’t look forward), to avoid shortening the sub occipitals.
4. Pull weight to chest while maintaining high elbows, pausing at the top of the movement. The forearms and wrist should remain perpendicular to the floor. Return the weight to start position and repeat for the designated number of reps.

Alternating Unilateral Bent-Over Row
1. Stand with feet pedal-width apart holding a pair of dumbbells with a supinated grip, chest out, shoulders back, navel in.
2. Soften the knees (approximately 20° bend).
3. Pivot forward at the hips so that the torso is positioned between 45 and 90° in relation to the legs. The angle should be dictated by the flexibility in the hamstrings—if the back starts to round or you lose your neutral lumbar and thoracic curves, you have bent over too much. Head should remain in neutral, too, (i.e., don’t look forward).
4. Pull non-dominant hand to chest while maintaining a high elbow and keeping the forearm and wrist should perpendicular to the floor. Return the weight to start position while simultaneously performing the exact same movement on the opposite side.
5. Repeat for the designated number of reps.

Alternating Unilateral Bent-Over Row on Bosu
1. Stand on a Bosu with feet pedal-width apart holding a pair of dumbbells with a supinated grip, chest out, shoulders back, navel in.
2. Soften the knees (approximately 20° bend).
3. Pivot forward at the hips so that the torso is positioned between 45 and 90° in relation to the legs. The angle should be dictated by the flexibility in the hamstrings—if the back starts to round or you lose your neutral lumbar and thoracic curves, you have bent over too much. Head should remain in neutral, too, (i.e., don’t look forward).
4. Pull non-dominant hand to chest while maintaining a high elbow and keeping the forearm and wrist should perpendicular to the floor. Return the weight to start position while simultaneously performing the exact same movement on the opposite side.
5. Repeat for the designated number of reps.

NOTE: The following exercises are the ones which should be utilized when the training program calls for “back extension” movements.

Twisting Back-Extension (on Ball)
1. Lie in the prone position (navel down) with arms above the head, palms down.
2. Inhale and lift the chest off the ground, rotating to the non-dominant side so that one shoulder is higher than the other. Lower body should remain relaxed with feet on the floor. Those whose lumbar curvature is excessive should concentrate on initiating the movement by squeezing the glutes first so that recruitment of the lumbar erectors is not excessive. Make sure chin stays tucked so that head is aligned with the rest of the spine to avoid shortening of the sub occipitals.
3. Lower chest back to the floor and perform the exact same movement in the opposite direction before repeating for the designated number of reps.
OR
1. Lie in the prone position on a physio ball with hands on the floor below the shoulders.
2. Inhale and lift the chest off the ball while simultaneously rotating to the non-dominant side. The non-dominant arm should swing down toward the legs and the dominant side should swing up above the head. Keep the lower body relaxed with feet on the floor. Those whose lumbar curvature is excessive should concentrate on initiating the movement by squeezing the glutes first so that recruitment of the lumbar erectors is not excessive. Make sure chin stays tucked and the head is aligned with the rest of the spine.
3. Lower chest back toward the ball and perform the exact same movement in the opposite direction before repeating for the designated number of reps.

Prone Cobra on Ball
1. Lie in the prone position on a physio ball with arms by the sides of the body, palms up.
2. Inhale and lift the chest off the ball, aiming to reverse the thoracic curvature while supinating the arms and squeezing the shoulder blades together. Keep the lower body relaxed with feet on the floor. Those whose lumbar curvature is excessive should concentrate on initiating the movement by squeezing the glutes first so that recruitment of the lumbar erectors is not excessive. Make sure chin stays tucked so that head is aligned with the rest of the spine to avoid shortening of the sub occipitals.
3. Hold for the designated period of time.

Reverse Hyper-Extension on Ball
1. Lie in the prone position on a physio ball with hands on the floor below the shoulders.
2. Inhale and lift the legs off the ground, aiming to get them perpendicular to the floor. Those whose lumbar curvature is excessive should concentrate on initiating the movement by squeezing the glutes first so that recruitment of the lumbar erectors is not excessive.
3. Return to start position and repeat for the designated number of reps.

Alternating Superman on Ball
1. Lie in the prone position with the navel in the center of the ball and the hands on the floor below the shoulders.
2. Inhale and lift the chest off the ground, aiming to reverse the thoracic curvature while supinating the arms and squeezing the shoulder blades together. Keep the lower body relaxed with feet on the floor. Those whose lumbar curvature is excessive should concentrate on initiating the movement by squeezing the glutes first so that recruitment of the lumbar erectors is not excessive. Make sure chin stays tucked so that head is aligned with the rest of the spine to avoid shortening of the sub occipitals.

Horse Stances (Vertical)
1. Get on hands and knees with hands directly beneath shoulders and knees directly beneath hips. Bend arms slightly at the elbow so that back is parallel to the floor. I recommend use of a dowel to ensure maintenance of a neutral spine. The dowel rod should touch the sacrum, the thoracic spine between the shoulder blades, and the back of the head.
2. Draw the TVA in toward the spine and activate the pelvic floor musculature. (Women: Perform a kegel. Men: Pull your testicles up toward your head.)
3. Lift one hand and the contralateral knee off the floor just enough to slip a piece of paper under it. If I were looking at you from the side, I should hardly be able to tell you’re moving at all.
4. Remain still, deviating neither side to side nor fore and aft, and hold this position for 5-10 seconds.
5. Repeat this procedure on the opposite sides, again holding for 5-10 seconds. Continue alternating sides for 8-10 reps each side.

Lunge Pattern Posted on November 26, 2013, 0 Comments

85% of gait takes place on one leg. Whether you’re pedaling perfect circles or in squares like most novices, you’re deriving most of your power from alternating legs while on the bike. Even swimming works the legs unilaterally. So while the squat pattern is a foundation for many movements in triathlon, the literal next step is the lunge. Performed correctly, it strengthens the hamstrings and the glutes—muscles often underdeveloped and underutilized on triathletes—as well as the quads. Additional benefits, from improved balance to ramped-up core recruitment, make this movement a critical one to master for the competitive triathlete.

NOTE: All of the lunge movements described below can be made more neurologically challenging and sport specific by adding arm movements such as bicep curls or shoulder presses. When doing so, always follow a cross-crawl pattern where the arm and the opposite leg work together. This will stimulate biomotor integration as well as help establish more connections in the corpus callosum, the part of the brain which connects the right hemisphere to the left hemisphere. Additionally, the Twist pattern can (and should when proficiency allows) be integrated into any of the lunge patterns below so that the legs learn to work in a coordinated fashion with the spine—as they should in the sport of triathlon and the sport of life!

First Descent—1 dowel-rod support
Second Descent—2 dowel-rod supports
Third Descent—Smith Machine

EXAMPLE EXERCISES

Lunge
1. Standing with Good Posture, take a step forward with the non-dominant leg so that the shin is perpendicular to the ground when the thigh is at parallel. Knee should track over foot throughout the movement. Torso should remain upright and the trailing leg should be bent with the knee almost touching the floor (as flexibility/strength allow) while ball of foot stays in contact with the ground.
2. Pushing through the heel, return to start position and repeat on the opposite side.

Backward Lunge
1. Standing with Good Posture, take a step backward with the dominant leg so that the shin of the forward/non-dominant leg is perpendicular to the ground when the thigh is at parallel. Knee should track over foot throughout the movement. Torso should remain upright and the trailing leg should be bent with the knee almost touching the floor (as flexibility/strength allow) while ball of foot stays in contact with the ground.
2. Pushing through the heel, return to start position and repeat on the opposite side.

Side Lunge
1. Standing with Good Posture, take a step to the side with the non-dominant leg.
2. Once in this straddle position, continue the lateral motion by bending the knee of the non-dominant leg. Feet should remain relatively square or externally rotated slightly. Torso will naturally incline forward, but chest should stay upright. Go as deep as possible without the dropping the chest, lifting the heel of the non-dominant foot off the ground, or bending the knee of the opposite leg which should be straight with the foot flat on the ground.
3. Pushing through the heel of the non-dominant leg, return to start position and repeat on the opposite side.

45° Lunge
1. Standing with Good Posture, take a step forward at a 45 degree angle with the non-dominant leg so that the shin of the forward/non-dominant leg is perpendicular to the ground when the thigh is at parallel. Knee should track over foot throughout the movement. Torso should remain upright and relatively square. Trailing leg should be supported by the ball of the foot with the knee angled at 45 degrees to maintain the integrity of this hinge joint.
2. Pushing through the heel, return to start position and repeat on the opposite side.

Clock Lunge
1. Standing with Good Posture, take a step forward with the non-dominant leg so that the shin is perpendicular to the ground when the thigh is at parallel. Knee should track over foot throughout the movement. Torso should remain upright and the trailing leg should be bent with the knee almost touching the floor (as flexibility/strength allow) while ball of foot stays in contact with the ground. Pushing through the heel, return to start position.
2. Take a step forward at a 45 degree angle with the non-dominant leg so that the shin of the forward/non-dominant leg is perpendicular to the ground when the thigh is at parallel. Knee should track over foot throughout the movement. Torso should remain upright and relatively square. Trailing leg should be supported by the ball of the foot with the knee angled at 45 degrees to maintain the integrity of this hinge joint. Pushing through the heel, return to start position.
3. Take a step to the side with the non-dominant leg. Once in this straddle position, continue the lateral motion by bending the knee of the non-dominant leg. Feet should remain relatively square or externally rotated slightly. Torso will naturally incline forward, but chest should stay upright. Go as deep as possible without the dropping the chest, lifting the heel of the non-dominant foot off the ground, or bending the knee of the opposite leg which should be straight with the foot flat on the ground. Pushing through the heel, return to the start position.
4. Take a step backward at a 45 degree angle with the non-dominant leg so that the shin of the forward/dominant leg is perpendicular to the ground when the thigh is at parallel. Knee should track over foot throughout the movement. Torso should remain upright and relatively square. Trailing leg should be supported by the ball of the foot with the knee angled at 45 degrees to maintain the integrity of this hinge joint. Pushing through the heel, return to start position.
5. Take a step backward with the non-dominant leg so that the shin of the forward/dominant leg is perpendicular to the ground when the thigh is at parallel. Knee should track over foot throughout the movement. Torso should remain upright and the trailing leg should be bent with the knee almost touching the floor (as flexibility/strength allow) while ball of foot stays in contact with the ground. Pushing through the heel, return to start position.
6. Repeat all movements with the dominant leg.

Lunge Walk
1. Standing with Good Posture, take a step forward with the non-dominant leg so that the shin is perpendicular to the ground when the thigh is at parallel. Knee should track over foot throughout the movement. Torso should remain upright and the trailing leg should be bent with the knee almost touching the floor (as flexibility/strength allow) while ball of foot stays in contact with the ground.
2. Pushing through the heel, move forward to a standing position and repeat on the opposite side

45° Lunge Walk
1. Standing with Good Posture, take a step forward at a 45 degree angle with the non-dominant leg so that the shin of the forward/non-dominant leg is perpendicular to the ground when the thigh is at parallel. Knee should track over foot throughout the movement. Torso should remain upright and relatively square. Trailing leg should be supported by the ball of the foot with the knee angled at 45 degrees to maintain the integrity of this hinge joint.
2. Pushing through the heel, more forward to a standing position and repeat on the opposite side.

Run Pose
1. Standing with Good Posture in lunge position with non-dominant leg forward, push through the heel as you move into a standing position supported by the ball of the foot of the non-dominant leg. Knee of the dominant leg should be driven toward chest. Support leg’s knee should track over foot throughout the movement, and the torso should remain upright. Arms should work in a cross-crawl pattern so that the left arm moves forward when the right leg is forward and vise versa.
2. Perform all repetitions on one side before repeating on the opposite side.

Backward Lunge Walk
1. Standing with Good Posture, take a step backward with the dominant leg so that the shin of the forward/non-dominant leg is perpendicular to the ground when the thigh is at parallel. Knee should track over foot throughout the movement. Torso should remain upright and the trailing leg should be bent with the knee almost touching the floor (as flexibility/strength allow) while ball of foot stays in contact with the ground.
2. Pushing through the heel, return backward to a standing position and repeat on the opposite side.

Bosu Lunge
1. Standing with Good Posture, with the non-dominant leg in the center of Bosu, take a step backward with the dominant leg so that the shin of the forward/non-dominant leg is perpendicular to the ground when the thigh is at parallel. Knee should track over foot throughout the movement. Torso should remain upright and the trailing leg should be bent with the knee almost touching the floor (as flexibility/strength allow) while ball of foot stays in contact with the ground.
2. Pushing through the heel, return to start position and continue with the designated number of reps before repeating on the opposite side.

Statin and Health Studies Posted on November 13, 2013, 0 Comments

Am J Cardiovasc Drugs. 2008;8(6):373-418. doi: 10.2165/0129784-200808060-00004.
Statin adverse effects : a review of the literature and evidence for a mitochondrial mechanism.
Golomb BA, Evans MA.
Source
Department of Medicine, University of California, San Diego, California 92093-0995, USA. bgolomb@ucsd.edu
Abstract
HMG-CoA reductase inhibitors (statins) are a widely used class of drug, and like all medications, have potential for adverse effects (AEs). Here we review the statin AE literature, first focusing on muscle AEs as the most reported problem both in the literature and by patients. Evidence regarding the statin muscle AE mechanism, dose effect, drug interactions, and genetic predisposition is examined. We hypothesize, and provide evidence, that the demonstrated mitochondrial mechanisms for muscle AEs have implications to other nonmuscle AEs in patients treated with statins. In meta-analyses of randomized controlled trials (RCTs), muscle AEs are more frequent with statins than with placebo. A number of manifestations of muscle AEs have been reported, with rhabdomyolysis the most feared. AEs are dose dependent, and risk is amplified by drug interactions that functionally increase statin potency, often through inhibition of the cytochrome P450 3A4 system. An array of additional risk factors for statin AEs are those that amplify (or reflect) mitochondrial or metabolic vulnerability, such as metabolic syndrome factors, thyroid disease, and genetic mutations linked to mitochondrial dysfunction. Converging evidence supports a mitochondrial foundation for muscle AEs associated with statins, and both theoretical and empirical considerations suggest that mitochondrial dysfunction may also underlie many nonmuscle statin AEs. Evidence from RCTs and studies of other designs indicates existence of additional statin-associated AEs, such as cognitive loss, neuropathy, pancreatic and hepatic dysfunction, and sexual dysfunction. Physician awareness of statin AEs is reportedly low even for the AEs most widely reported by patients. Awareness and vigilance for AEs should be maintained to enable informed treatment decisions, treatment modification if appropriate, improved quality of patient care, and reduced patient morbidity.

Statin therapy decreases myocardial function as evaluated via strain imaging.
http://www.ncbi.nlm.nih.gov/pubmed/20027659
Rubinstein J, Aloka F, Abela GS.
Source
Cardiology Division, Department of Medicine, Michigan State University, East Lansing, MI 48824, USA.
Abstract
OBJECTIVES:
The purpose of this study was to evaluate the effects of statin therapy on myocardial function as measured with echocardiography with tissue Doppler imaging (TDI) and strain imaging (SI) independent of its lipid-lowering effect.
BACKGROUND:
Statin use is known to improve outcomes in the primary and secondary prevention of ischemic heart disease, but their use is also associated with myopathy, muscle weakness and in rare cases, rhabdomyolysis. We sought to evaluate whether TDI and SI is able to identify changes in myocardial function associated with statin use.
METHODS:
Myocardial function was evaluated in 28 patients via echocardiography with TDI and SI. We identified 12 patients (5 females) without overt cardiovascular disease (including hypertension, smoking, and diabetes) that were on statin therapy and compared their echocardiographic findings with 16 (12 females) age, sex, and cholesterol-profile-matched controls. Tissue Doppler imaging parameters of diastolic (E(')/A(') and E/E(')) and systolic (S') function were measured. Regional systolic function was obtained by SI in 4-chamber, 2-chamber, long axis, and average global views.
RESULTS:
There was no significant difference in myocardial function as measured by Doppler and minor differences as measured via TDI among the 2 groups. There was significantly better function noted with SI in the control group vs the statin group in the 4-chamber (-19.05% +/- 2.45% vs -16.47% +/- 2.37% P = 0.009), 2-chamber (-20.30% +/- 2.66% vs -17.45% +/- 4.29% P = 0.03), long axis (-17.63% +/- 3.79% vs -13.83% +/- 3.74% P = 0.01), and average global (-19.0% +/- 2.07% vs -15.91% +/- 2.81% P = 0.004) views.
CONCLUSION:
Statin therapy is associated with decreased myocardial function as evaluated with SI.

Nutr Metab Cardiovasc Dis. 2005 Feb;15(1):36-41.
Lipid-lowering drugs and essential omega-6 and omega-3 fatty acids in patients with coronary heart disease.
de Lorgeril M, Salen P, Guiraud A, Zeghichi S, Boucher F, de Leiris J.
Source
Laboratoire Nutrition, Vieillissement et Maladies Cardiovasculaires (NVMCV), UFR de Médecine, Université Joseph Fourier, Grenoble, France. michel.delorgeril@ujf-grenoble.fr
Abstract
BACKGROUND AND AIM:
There are only little data about the effects of lipid-lowering drugs (LLDs) on the metabolism of essential n-6 and n-3 fatty acids in patients with established coronary heart disease (CHD).
METHODS AND RESULTS:
Male patients with CHD and high cholesterol levels (>6.2 mmol/L) were randomized (double-blind protocol) to receive either simvastatin 20mg (S) or fenofibrate 200mg daily (F) for 3 months. Dietary habits and plasma fatty acids were not different in the two groups at baseline. After treatment, there were significant changes in both the groups for the main n-6 fatty acids, with an increase in arachidonate (from 6.5+/-1.7% of total fatty acids to 7.5+/-2.1, p<0.001 in S and from 6.2+/-1.4 to 6.8+/-1.4, p<0.005 in F) and a decrease in linoleate (from 26.9+/-3.9 to 24.2+/-3.6, p<0.001, and from 27.8+/-3.4 to 26.1+/-4.2, p<0.05, in S and F, respectively). In addition, there was a decrease in two major n-3 fatty acids (alpha-linolenate and docosahexanoate, both p<0.05), but only in F.
CONCLUSIONS:
For the first time in a double-blind randomized study in CHD patients, we report that LLDs significantly alter the metabolism of essential fatty acids that are critically important for the pathogenesis and prevention of CHD. Further studies are urgently needed to examine the effects of higher dosages of statins (as currently proposed to reduce more cholesterol) on these essential fatty acids in the clinical setting and the crucial questions of whether specific dietary intervention (combining low intake of n-6 fatty acids and high intake of n-3 fatty acids) may improve the effectiveness of these drugs.

J Epidemiol Community Health. 2004 Dec;58(12):1047-51.
Lipid lowering drugs prescription and the risk of peripheral neuropathy: an exploratory case-control study using automated databases.
Corrao G, Zambon A, Bertù L, Botteri E, Leoni O, Contiero P.
Source
Dipartimento di Statistica, Università degli Studi di Milano-Bicocca, Via Bicocca degli Arcimboldi 8, Edificio U7, 20126 Milan, Italy. giovanni.corrao@unimib.it
Abstract
STUDY OBJECTIVE:
Although lipid lowering drugs are effective in preventing morbidity and mortality from cardiovascular events, the extent of their adverse effects is not clear. This study explored the association between prescription of lipid lowering drugs and the risk of peripheral neuropathy.
DESIGN:
A population based case-control study was carried out by linkage of several automated databases.
SETTING:
Resident population of a northern Italian Province aged 40 years or more.
PARTICIPANTS:
Cases were patients discharged for peripheral neuropathy in 1998-1999. For each case up to 20 controls were randomly selected among those eligible. Altogether 2040 case patients and 36 041 controls were included in the study. Exposure ascertainment: Prescription drug database was used to assess exposure to lipid lowering drugs at any time in the one year period preceding the index date.Analysis: Conditional logistic regression model for matched data was used to estimate the risk of peripheral neuropathy associated with exposure to statins, fibrates, and other lipid lowering drugs.
MAIN RESULTS:
Weak but significant effects of lipid lowering drugs as a whole (matched odds ratio: 1.27; 95% confidence intervals: 1.05 to 1.55), statins (1.19; 1.00 to 1.40), and fibrates (1.49; 1.03 to 2.17) were observed. Significant linear trends towards increased risk at increased exposure to both statins and fibrates were observed.
CONCLUSIONS:
The use of both statins and fibrates was associated with the risk of peripheral neuropathy. The primary purpose of this exploratory study is signal generation. This requires further investigations to evaluate the causal role of lipid lowering drugs on the onset of peripheral neuropathy.
http://www.ncbi.nlm.nih.gov/pubmed/15025753
Br J Clin Pharmacol. 2004 Apr;57(4):525-8.


Professional athletes suffering from familial hypercholesterolaemia rarely tolerate statin treatment because of muscular problems.
Sinzinger H, O'Grady J.
Source
Wilhelm Auerswald Atherosclerosis Research Group (ASF) Vienna, Institute for Diagnosis and Treatment of Atherosclerosis and Lipid Disorders (ATHOS), Vienna, Austria. helmut.sinzinger@univie.ac.at
Abstract
AIMS:
Muscular problems are the major group of side-effects during statin treatment. They are known to occur much more frequently during and after exercise.
METHODS AND RESULTS:
For the last 8 years we have monitored 22 professional athletes in whom, because of familial hypercholesterolaemia, treatment with different statins was attempted. Only six out of the 22 finally tolerated at least one member of this family of drugs. In three of these six the first statin prescribed allowed training performance without any limitation. Changing the drug demonstrated that only two tolerated all the four or five statins examined (atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin). Cerivastatin was not among the statins prescribed.
CONCLUSIONS:
These findings indicate that in top sports performers only about 20% tolerate statin treatment without side-effects. Clinical decision making as to lipid lowering therapy thus becomes a critical issue in this small subgroup of patients.

http://www.ncbi.nlm.nih.gov/pubmed/9322808
Metabolism. 1997 Oct;46(10):1206-10.
Lovastatin increases exercise-induced skeletal muscle injury.
Thompson PD, Zmuda JM, Domalik LJ, Zimet RJ, Staggers J, Guyton JR.
Source
Division of Cardiology, University of Pittsburgh, PA, USA.
Abstract
This study tested the hypothesis that exercise in combination with a 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor produces greater creatine kinase (CK) elevations, an index of skeletal muscle injury, than exercise alone, using a double-blind, placebo-controlled design. Fifty-nine healthy men aged 18 to 65 years with low-density lipoprotein cholesterol (LDL-C) levels greater than 3.36 mmol/L (130 mg/dL) despite diet therapy were studied. Subjects were randomly assigned to receive lovastatin (40 mg/d) or placebo for 5 weeks. Subjects completed 45 minutes of downhill treadmill walking (-15% grade) at 65% of their predetermined maximum heart rate after 4 weeks of treatment. During the subsequent week, they completed four 10-repetition sets of one-arm biceps curl exercise using 50% of their maximum capacity. CK levels were measured before exercise and daily for 4 and 5 days after the treadmill and biceps exercises, respectively. Age, body weight, and blood lipid and lipoprotein levels were similar in lovastatin and placebo groups. Resting CK levels were 33% higher in the lovastatin group before treatment (P < .05), but were not significantly altered by lovastatin. CK levels were 62% and 77% higher (P < .05) in the lovastatin group 24 and 48 hours after treadmill exercise after adjusting for initial CK differences. There were no significant CK differences between lovastatin and placebo groups after biceps curl exercise. We conclude that HMG-CoA reductase inhibitors exacerbate exercise-induced skeletal muscle injury.

http://www.ncbi.nlm.nih.gov/pubmed/15107601
Cardiovasc Drugs Ther. 2003 Sep-Nov;17(5-6):459-65.
A comprehensive description of muscle symptoms associated with lipid-lowering drugs.
Franc S, Dejager S, Bruckert E, Chauvenet M, Giral P, Turpin G.
Source
Department of Endocrinology, Hôpital de La Pitié-Salpétrière, Assistance Publique-Hôpitaux de Paris, 83 Bd de L'Hôpital, 75013 Paris, France. sylvia.franc@free.fr
Abstract
A spectrum of disease from myalgia to rhabdomyolysis exists as classic side-effect of lipid-lowering treatment (LLT). While myopathy has generated considerable interest, mild musculo-skeletal symptoms are poorly assessed.
OBJECTIVE:
To report on the muscular side-effects of LLT with a particular focus on the overlooked milder ones.
METHODS:
Hyperlipidemic patients under LLT and complaining of muscle symptoms were asked to complete a self administered questionnaire. Among the 815 adult hyperlipidemic patients under LLT and referred to the cardiovascular prevention unit of La Pitie Hospital, 165 patients answered that they experienced, or had experienced, muscle symptoms which they attributed to the LLT. One hundred and thirty three of these completed and returned a self-administered questionnaire.
RESULTS:
A clear chronological link between symptoms and the LLT was revealed, either because they appeared soon after drug initiation or because of an improvement after drug withdrawal. While cramps and stiffness were the most frequent symptoms, tendonitis-associated pain was surprisingly common, reported in almost half the cases. Pain was often diffuse with a focus on a given location, mainly lower limbs. 39% of patients had used analgesics for pain relief. Unpredictably, a majority of patients reported pain during rest and the lying position. In a number of cases, a family history of pain under LLT was revealed.
CONCLUSION:
The impact of these mild symptoms on daily activities might not be negligible in a subset of patients. The role and importance of a genetic background predisposing to low-grade myopathy deserves further investigation.

Arch Intern Med. 2005 Dec 12-26;165(22):26716.
http://www.ncbi.nlm.nih.gov/pubmed/16344427
Outcomes in 45 patients with statin-associated myopathy.
Hansen KE, Hildebrand JP, Ferguson EE, Stein JH.
http://www.ncbi.nlm.nih.gov/pubmed/16799920
Source
Rheumatology Section, University of Wisconsin Medical School, H6/363 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792, USA. keh@medicine.wisc.edu
Abstract
BACKGROUND:
Published studies regarding statin-associated myopathy may describe more dramatic patient presentations, potentially leading to inaccurate characterization of the condition. Furthermore, long-term outcomes and responses to statin rechallenge in patients with statin-associated myopathy are largely unknown.
METHODS:
The University of Wisconsin Hospital and Clinics Medical Informatics Department identified 437 patients with International Classification of Diseases, Ninth Revision codes potentially representing cases of statin-associated myopathy from more than 13 years of inpatient and outpatient data; 45 of these individuals were diagnosed as having statin-associated myopathy. Using a standardized form, 2 researchers abstracted all the case records to define the clinical course of statin-induced myopathy.
RESULTS:
The mean (SD) duration of statin therapy before symptom onset was 6.3 (9.8) months. Resolution of muscle pain occurred a mean (SD) of 2.3 (3.0) months after discontinuation of statin therapy. Six patients (13%) were hospitalized for the management of rhabdomyolysis; 2 had reversible renal dysfunction, and 1 with preexisting renal insufficiency subsequently began lifelong dialysis. Hospitalized patients developed myopathy more quickly after initiating statin therapy (1.3 vs 7.1 months; P = .048) and were more likely to be taking concomitant medications known to increase the risk of statin-associated myopathy (P = .03). Thirty-seven patients received another statin after an episode of statin-associated myopathy; 21 (57%) reported recurrent muscle pain, whereas 16 (43%) tolerated other statins without recurrent symptoms.
CONCLUSIONS:
Patients with statin-associated myopathy experienced full resolution of muscle pain on cessation of statin therapy. Although no deaths occurred, 13% of the patients required hospitalization for rhabdomyolysis. Recurrent muscle pain was common on statin rechallenge.


J Pathol. 2006 Sep;210(1):94-102.
Statin therapy induces ultrastructural damage in skeletal muscle in patients without myalgia.
Draeger A, Monastyrskaya K, Mohaupt M, Hoppeler H, Savolainen H, Allemann C, Babiychuk EB.
Source
Institute of Anatomy, Department of Cell Biology, University of Bern, Baltzerstrasse 2, 3012 Bern, Switzerland. draeger@ana.unibe.ch
Abstract
Muscle pain and weakness are frequent complaints in patients receiving 3-hydroxymethylglutaryl coenzymeA (HMG CoA) reductase inhibitors (statins). Many patients with myalgia have creatine kinase levels that are either normal or only marginally elevated, and no obvious structural defects have been reported in patients with myalgia only. To investigate further the mechanism that mediates statin-induced skeletal muscle damage, skeletal muscle biopsies from statin-treated and non-statin-treated patients were examined using both electron microscopy and biochemical approaches. The present paper reports clear evidence of skeletal muscle damage in statin-treated patients, despite their being asymptomatic. Though the degree of overall damage is slight, it has a characteristic pattern that includes breakdown of the T-tubular system and subsarcolemmal rupture. These characteristic structural abnormalities observed in the statin-treated patients were reproduced by extraction of cholesterol from skeletal muscle fibres in vitro. These findings support the hypothesis that statin-induced cholesterol lowering per se contributes to myocyte damage and suggest further that it is the specific lipid/protein organization of the skeletal muscle cell itself that renders it particularly vulnerable.
Copyright (c) 2006 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Fam Pract. 2002 Feb;19(1):95-8.
http://www.ncbi.nlm.nih.gov/pubmed/11818357
Do lipid-lowering drugs cause erectile dysfunction? A systematic review.
Rizvi K, Hampson JP, Harvey JN.
Source
University of Wales College of Medicine, Wrexham Academic Unit, Wrexham, UK.
Abstract
BACKGROUND:
Erectile dysfunction (ED) is common although under-reported by patients. Along with the better known causes of ED, drug-induced impotence needs to be considered as a cause of this symptom. Lipid-lowering drugs have been prescribed increasingly. Their relationship to ED is controversial.
OBJECTIVES:
Our aim was to clarify the relationship between lipid-lowering therapy and ED. A secondary aim was to assess the value of the systematic review procedure in the area of adverse drug reactions.
METHODS:
A systematic review was carried out using computerized biomedical databases and Internet sources. Terms denoting ED were linked with terms referring to lipid-lowering drugs. Information was also sought from regulatory agencies.
RESULTS:
A significant literature was identified, much from obscure sources, which included case reports, review articles, and information from clinical trials and from regulatory agencies. Information from all of these sources identified fibrates as a source of ED. A substantial number of cases of ED associated with statin usage have been reported to regulatory agencies. Case reports and clinical trial evidence supported the suggestion that statins can also cause ED. Some information on possible mechanisms was obtained, but the mechanism remains uncertain.
CONCLUSIONS:
The systematic review procedure was applied successfully to collect evidence suggesting that both statins and fibrates may cause ED. More numerous reports to regulatory agencies complemented more detailed information from case reports to provide a new perspective on a common area of prescribing.

Drug Saf. 2006;29(12):1123-32.
http://www.ncbi.nlm.nih.gov/pubmed/17147459
Statins and pancreatitis: a systematic review of observational studies and spontaneous case reports.
Singh S, Loke YK.
Source
Department of Internal Medicine, Section on General Internal Medicine, Wake Forest University Health Sciences, Winston Salem, North Carolina, USA. sosingh@wfubmc.edu
Abstract
Many anecdotal reports have suggested that therapy with HMG-CoA reductase inhibitors ('statins') can cause acute pancreatitis. We aimed to quantify the association between statins and pancreatitis and to classify the adverse effect under the dose, time, susceptibility (DoTS) system. We searched for controlled observational studies that assessed the risk of pancreatitis in patients receiving statins. In order to identify case reports of statin-induced pancreatitis, we looked for reports published in scientific journals and manually reviewed reports within the Canadian Adverse Drug Event Monitoring System (CADRMP) database. Two observational studies were identified and the data pooled together in a meta-analysis. This yielded an odds ratio of 1.41 (95% CI 1.15, 1.74) for the risk of acute pancreatitis in patients with a past history of exposure to statins. We also identified 20 published case reports and 33 spontaneous reports from the CADRMP database. These data showed that pancreatitis can occur at both high and low doses, with 12 cases developing pancreatitis at less than the dose equivalent of simvastatin 20 mg daily. Statin-induced pancreatitis can occur at any time but seems to be very uncommon early on and more likely to occur after many months of therapy. There does not appear to be a cumulative dose effect and increasing age does not appear to be a major susceptibility factor. These finding should help clinicians to better manage and diagnose patients who are at risk of statin-induced pancreatitis.

CMAJ. 2007 Feb 27;176(5):649-54.
http://www.ncbi.nlm.nih.gov/pubmed/17325332
Does pravastatin promote cancer in elderly patients? A meta-analysis.
Bonovas S, Sitaras NM.
Source
Department of Pharmacology, School of Medicine, University of Athens Athens, Greece. sbonovas@med.uoa.gr
Abstract
BACKGROUND:
An increase in the incidence of cancer among elderly people assigned to pravastatin therapy has been reported in a randomized controlled trial; however, this finding has been attributed to chance. Our aim was to assess the effect of pravastatin therapy on cancer risk and to examine whether the effect varies according to age by performing a detailed meta-analysis and meta-regression analysis of randomized controlled trials.
METHODS:
We performed a comprehensive literature search for relevant studies published before February 2006. Before analysis, the selected studies were evaluated for publication bias and heterogeneity. Pooled relative risk estimates with 95% confidence intervals (CIs) were calculated using fixed-and random-effects models. Meta-regression analysis was performed to examine the impact of age on the study estimates of the relative risk of cancer due to pravastatin therapy.
RESULTS:
Twelve trials that investigated the use of pravastatin therapy for cardiovascular outcomes were included in the analysis (n = 42 902). Although the overall association between pravastatin use and cancer was not statistically significant in the fixed-effects (risk ratio [RR] 1.06, 95% CI 0.99 - 1.13) or random-effects model (RR 1.06, 95% CI 0.97 - 1.14), the meta-regression analysis showed that the age of study participants significantly modified the effect of pravastatin therapy on cancer risk (p = 0.006). Specifically, this analysis showed that pravastatin therapy was associated with an increasing risk of cancer as age increased. This finding was remarkably robust in the sensitivity analysis.

Curr Opin Cardiol. 2011 Jul;26(4):342-7. doi: 10.1097/HCO.0b013e3283470359.
http://www.ncbi.nlm.nih.gov/pubmed/21499090
Are statins diabetogenic?
Sampson UK, Linton MF, Fazio S.
Source
Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee 37232-6300, USA. u.sampson@vanderbilt.edu
Abstract
PURPOSE OF REVIEW:
Statins are widely utilized for low-density lipoprotein lowering and for prevention of atherosclerotic cardiovascular disease. Although these drugs have a good safety record, increased risk of developing diabetes during extended use has recently garnered attention. Here we review clinical trial evidence related to statin use and incident diabetes, and the potential mechanisms for this association.
RECENT FINDINGS:
The increased incidence of diabetes with rosuvastatin treatment in Justification for the Use of Statins in Primary Prevention: an intervention Trial Evaluating Rosuvastatin (JUPITER) reignited attention on the link between statin therapy and diabetes. The JUPITER findings are supported by two recent meta-analyses of large-scale placebo-controlled and standard care-controlled trials, which, respectively, observed a 9% [odds ratio 1.09; 95% confidence interval (CI) 1.02-1.17] and 13% (risk ratio 1.13; 95% CI 1.03-1.23) increased risk for incident diabetes associated with statin therapy. However, the underlying mechanisms for this association remain unclear. Experimental evidence supports a paradigm implicating inhibition of β-cell glucose transporters, delayed ATP production, pro-inflammatory and oxidative β-cell effects of plasma-derived cholesterol, inhibition of calcium channel-dependent insulin secretion, and β-cell apoptosis.
SUMMARY:
The aggregate of large clinical trials supports the notion that statins modestly increase the risk of incident diabetes. Because diabetes is a risk equivalent condition for coronary and peripheral arterial diseases, these findings create a paradox whereby needed statin therapy may be withheld to avoid excess risk of diabetes while representing the strongest cardiovascular risk reduction tool in diabetics. We simply recommend regular glucose monitoring in patients taking statins.
INTERPRETATION:
Our findings suggest an association between pravastatin therapy and cancer in elderly patients. However, given the importance of this potential association, further verification is warranted.

The effect of statins on testosterone in men and women, a systematic review and meta-analysis of randomized controlled trials.
Schooling CM, Au Yeung SL, Freeman G, Cowling BJ.
Source
CUNY School of Public Health at Hunter College, 2180 Third Avenue, New York, NY 10035, USA. mschooli@hunter.cuny.edu
Abstract
BACKGROUND:
Statins are extensively used for cardiovascular disease prevention. Statins reduce mortality rates more than other lipid-modulating drugs, although evidence from randomized controlled trials also suggests that statins unexpectedly increase the risk of diabetes and improve immune function. Physiologically, statins would be expected to lower androgens because statins inhibit production of the substrate for the local synthesis of androgens and statins' pleiotropic effects are somewhat similar to the physiological effects of lowering testosterone, so we hypothesized that statins lower testosterone.
METHODS:
A meta-analysis of placebo-controlled randomized trials of statins to test the a priori hypothesis that statins lower testosterone. We searched the PubMed, Medline and ISI Web of Science databases until the end of 2011, using '(Testosterone OR androgen) AND (CS-514 OR statin OR simvastatin OR atorvastatin OR fluvastatin OR lovastatin OR rosuvastatin OR pravastatin)' restricted to randomized controlled trials in English, supplemented by a bibliographic search. We included studies with durations of 2+ weeks reporting changes in testosterone. Two reviewers independently searched, selected and assessed study quality. Two statisticians independently abstracted and analyzed data, using random or fixed effects models, as appropriate, with inverse variance weighting.
RESULTS:
Of the 29 studies identified 11 were eligible. In 5 homogenous trials of 501 men, mainly middle aged with hypercholesterolemia, statins lowered testosterone by -0.66 nmol/l (95% confidence interval (CI) -0.14 to -1.18). In 6 heterogeneous trials of 368 young women with polycystic ovary syndrome, statins lowered testosterone by -0.40 nmol/l (95% CI -0.05 to -0.75). Overall statins lowered testosterone by -0.44 nmol/l (95% CI -0.75 to -0.13).
CONCLUSIONS:
Statins may partially operate by lowering testosterone. Whether this is a detrimental side effect or mode of action warrants investigation given the potential implications for drug development and prevention of non-communicable chronic diseases. See commentary article here http://www.biomedcentral.com/1741-7015/11/58.

Push Pattern Posted on November 10, 2013, 0 Comments

In reality, muscles do not push. Movements, even pushing ones, occur because a muscle (or muscles) contracts or shortens and pulls the origin and insertion closer together. Even during a push up, the triceps contract to pull the origin and insertion closer together, causing the arms to extend and the body to rise away from the ground. This, of course, is achieved with the help of additional actions of the pectorals and deltoids (not to mention countless core muscles essential to a proper push up. These are the same muscles often lacking in a guy who has a 250-pound bench, yet can’t hold his pelvis level to perform a decent push up). In the sport of triathlon, forward propulsion is achieved mainly by the action of these muscles. This section will focus exclusively on the upper-body pushing movements.

NOTE: Anytime you do unilateral (i.e. single arm) Pull or Push Patterns, you are creating a rotational force and, thus, mobilizing the spine. This not only helps nourish the spine by pumping the spinal discs with the fluids essential for health, it’s also specific to the movement patterns involved in triathlon.

First Descent—Braced
Second Descent—Seated or lying
Third Descent—Seated or lying on fixed-axis machine

EXAMPLE EXERCISES

Push Ups
1. In prone position with arms outstretched and hands placed shoulder width apart, lower the body down until the upper arm is approximately parallel with the floor.
2. Return to start position and repeat.

Decline Push Ups
1. In prone position with arms outstretched, hands placed shoulder width apart, and feet on an elevated surface, lower the body down until the upper arm is approximately parallel with the floor.
2. Return to start position and repeat.

Medicine-Ball Push Ups
1. In prone position with arms outstretched and hands placed on a medicine ball, lower the body down until the upper arm is approximately parallel with the floor.
2. Return to start position and repeat.

Bosu Push Ups
1. In prone position with arms outstretched and hands placed shoulder width apart on a Bosu, lower the body down until the upper arm is approximately parallel with the floor.
2. Return to start position and repeat.

Hands-on-Physio-Ball Push Ups
1. In prone position with arms outstretched and hands placed shoulder width apart on a physio ball, lower the body down until the chest just touches the ball.
2. Return to start position and repeat.

Feet-on-Physio-Ball Push Ups
1. In prone position with arms outstretched, hands placed shoulder width apart, and feet (or foot to increase neurological complexity) on a physio ball, lower the body down until the upper arm is approximately parallel with the floor.
2. Return to start position and repeat.

Shoulder Press
1. Standing with Good Posture, hands holding two dumbbells just above the shoulders with palms facing forward, extend arms overhead.
2. Return to start position and repeat.

Arnie Press
1. Standing with Good Posture, hands holding two dumbbells at shoulder height with palms facing body, extend arms overhead so that palms end the movement facing forward.
2. Return to start position and repeat.

Unilateral Arnie Press
1. Standing with Good Posture on the dominant leg, hands holding two dumbbells at shoulder height with palms facing body, extend non-dominant arm overhead so that the palm ends the movement facing forward.
2. Return to start position and repeat with the opposite arm, switching stance legs once half the reps in the set are completed.

Bosu Arnie Press
1. Standing with Good Posture on a Bosu, hands holding two dumbbells at shoulder height with palms facing body, extend arms overhead so that palms end the movement facing forward.
2. Return to start position and repeat.

Kneeling-on-Physio-Ball Arnie Press
1. Kneeling with Good Posture on a physio ball, hands holding two dumbbells at shoulder height with palms facing body, extend arms overhead so that palms end the movement facing forward.
2. Return to start position and repeat.

Straight-Arm Push Downs
1. Stand with Good Posture, hands holding a bar with a pronated grip, swim width apart.
2. Push down and bring hands toward the legs until bar touches thighs. Do not allow arms to bend at elbows as pivot point is at the shoulders.
3. Return to start position and repeat.

Unilateral Straight-Arm Push Downs
1. Stand with Good Posture, non-dominant hand holding a handle with a pronated grip.
2. Push down and bring hand toward the legs until it is beside or even behind the thigh. Do not allow arm to bend at elbow as pivot point is at the shoulder.
3. Return to start position and repeat.

Cable Push
1. Stand in a counter stance with Good Posture while holding a handle at shoulder level with the non-dominant hand and a pronated grip. The arm should be pulled back so the elbow is high and the forearm parallel to the angle of the dominant arm which should be outstretched in front of the body, palm down.
2. Push non-dominant hand away from the body while simultaneously rotating along the axis of the spine to the dominant side. Hands should switch places so that the dominant hand is now at shoulder level with a high elbow and the other arm is outstretched in front of the body with the palm facing down.
3. Return to start position and continue for the designated number of reps before repeating on the opposite side.

Swim
1. Stand facing a cable machine with non-dominant side holding a dumbbell at shoulder height with palm facing body and the dominant side holding a handle at shoulder height with palm facing forward and the elbow glued to the side of the body.
2. Simultaneously extend the non-dominant side overhead while pressing the handle down until the dominant arm is fully extended.
3. Return to start position and continue for the designated number of reps before repeating on the opposite side(s).

Pull Pattern Posted on November 05, 2013, 0 Comments

Another one of the seven primal patterns, pulling movements are often neglected or underdeveloped compared to their sister pattern, pushing movements. This is often because people don’t have vision for what they can’t see. When you “see” a tree, you don’t really see the whole tree. You don’t see its roots. You don’t see the other side of the trunk or the top of the canopy. Yet the tree could never be fully developed without them. So just because you can’t see the muscles of your posterior chain does not mean you should ignore them. You are more than just your mirror muscles. In fact, it is the predominance of anterior chain movements in triathlon which make pulling proficiency so important for triathletes to maintain postural balance along with orthopedic health.

NOTE: Anytime you do unilateral (i.e. single arm) Pull or Push Patterns, you are creating a rotational force and, thus, mobilizing the spine. This not only helps nourish the spine by pumping the spinal discs with the fluids essential for health, it’s also specific to the movement patterns involved in triathlon.

First Descent—Braced
Second Descent—Seated or lying
Third Descent—Seated or lying on fixed-axis machine

EXAMPLE EXERCISES

Low Row
1. Standing with Good Posture and holding a bar with a supinated grip, shoulder width apart, pull hands toward body so sides of wrists finish at rib cage as the bar touches the torso near the level of the sternum.
2. Return to start position and repeat.

Unilateral Row
1. Standing with Good Posture and holding a handle with a pronated grip, pull hand toward body, supinating the hand so the wrist finishes at the side of the rib cage at approximately the level of the sternum.
2. Return to start position and repeat.

High Row
1. Standing with Good Posture and holding two handles (or a bar if necessary) with a pronated grip, a bit wider than shoulder width apart, pull hands toward body while keeping the elbows high and the forearms in the same plane as the angle of pull. Wrists should remain neutral (i.e. not flexed) and finish movement at approximately shoulder level.
2. Return to start position and repeat.

High Row with Rotation
1. Stand with Good Posture, holding two handles with a supinated grip, shoulder width apart. Initiate movement by rotating torso to the non-dominant side. Simultaneously pull handle held by non-dominant hand toward body while keeping the elbow high and the forearm in the same plane as the angle of pull. Wrists should remain neutral and finish the movement at approximately shoulder level.
2. Return to start position and repeat on the opposite side.

Suspended Row
1. Maintain Good Posture while leaning back at the appropriate angle (difficulty increases as angle steepens) and holding the handles of a suspension system with a pronated grip, shoulder width apart.
2. Pull body toward handles while maintaining high elbows and forearms in the same plane as the angle of pull which should perpendicular to the body. Wrists should remain neutral and finish at approximately shoulder level.
3. Return to start position and repeat.

Pull Ups/Chin Ups
1. Stand with Good Posture while grasping a Pull Up Bar above the head. Grip should be swim width apart and pronated for a Pull UP or shoulder width apart and supinated for a Chin Up.
2. Pull body towards hands until chin passes over the bar. Legs should not swing forward at any time during the movement.
3. Return to start position and repeat.

Overhand Pull Down
1. Kneeling or seated with Good Posture holding two handles or a bar with a pronated grip, swim-width apart, pull hands toward body until handles go below chin level but not below the clavicle.
2. Return to start position and repeat.

Cable Pulls
1. Stand in a counter stance with Good Posture while holding a handle with the non-dominant hand and a pronated grip. The other arm should be pulled back so the wrist is at approximately shoulder level with the elbow high and the forearm parallel to the angle of the other arm.
2. Pull hand toward body while simultaneously rotating along the axis of the spine to the non-dominant side. Hands should switch places so that the non-dominant side is now at shoulder level with a high elbow and the other arm is outstretched in front of the body with the palm facing down.
3. Return to start position and continue for the designated number of reps before repeating on the opposite side.

Abdominal Specific Movements Posted on November 02, 2013, 0 Comments

EXAMPLE EXERCISES                          

 

Four-Point TVA Stance and Progressions

  1. Get on hands and knees with the hands directly beneath the shoulders and the knees directly beneath the hips.       Bend arms slightly at the elbow so that the back is parallel to the floor. I recommend use of a dowel to ensure maintenance of a neutral spine. The dowel rod should touch the sacrum, the thoracic spine between the shoulder blades, and the back of the head.
  2. Take a large diaphragmatic breath in through the nose and allow the belly to expand and the navel to drop away from the spine. Exhale and then activate the TVA to draw the navel in toward the spine as far as possible without flexing the spine/losing neutral spinal curvatures or compensating/cheating in any way. The only part of the body which should visibly move is the navel.       It may help to concentrate on activating the pelvic floor musculature. (Women: Perform a kegel.       Men: Pull your testicles up toward your head).
  3. Hold this position until it’s necessary to take another breath. Then repeat the process for the designated number of reps/breaths.

 

OR

 

  1. Get in shortstop position with the hands on the knees. Knees should be bent slightly and spinal curvatures should remain in neutral (i.e. don’t round the lower back).
  2. Take a large diaphragmatic breath in through the nose and allow the belly to expand and the navel to drop away from the spine. Exhale and then activate the TVA to draw the navel in toward the spine as far as possible without flexing the spine/losing neutral spinal curvatures or compensating/cheating in any way. The only part of the body which should visibly move is the navel.       It may help to concentrate on activating the pelvic floor musculature. (Women: Perform a kegel.       Men: Pull your testicles up toward your head).
  3. Hold this position until it’s necessary to take another breath. Then repeat the process for the designated number of reps/breaths.

 

OR

 

  1. Stand with Good Posture.
  2. Take a large diaphragmatic breath in through the nose and allow the belly to expand and the navel to move away from the spine. Exhale and then activate the TVA to draw the navel in toward the spine as far as possible without flexing the spine/losing neutral spinal curvatures or compensating/cheating in any way. The only part of the body which should visibly move is the navel.       It may help to concentrate on activating the pelvic floor musculature. (Women: Perform a kegel.       Men: Pull your testicles up toward your head).
  3. Hold this position until it’s necessary to take another breath. Then repeat the process for the designated number of reps/breaths.

 

Lower Abdominal Series # 1—Pelvic Tilt

  1. In supine position with knees bent, feet on the floor, and a blood pressure cuff pumped to 40mmHg (or a hand) placed opposite the navel in the small of the back, gently draw in the navel.
  2. Flatten the lower back into the cuff (or the hand) by posteriorly rotating the pelvis using the lower abdominals to raise the pressure on the cuff to 70mmHg. Try to keep the hamstrings completely relaxed as they can also rotate the pelvis posteriorly. But if they do the work, the lower abdominals won’t.
  3. Breathe naturally as the pelvis is held in this position. Return to start and repeat for the designated number of reps.

 

Lower Abdominal Series #2A

  1. In supine position with knees bent, feet on the floor, and a blood pressure cuff (or a hand) placed opposite the navel in the small of the back, pump the cuff up to 40mmHg.
  2. Gently draw the navel in and then flatten the lower back into the cuff (or the hand) by posteriorly rotating the pelvis using the lower abdominals to raise the pressure on the cuff to 70mmHg.       Try to keep the hamstrings completely relaxed as they can also rotate the pelvis posteriorly. But if they do the work, the lower abdominals won’t.
  3. Pivoting at the hip, lift one leg up until the thigh is perpendicular to the body and the knee is at 90 (or less if the exercise needs to be made easier) while maintaining the pressure on the cuff at 70mmHg, varying no more than +/-5mmHg throughout the exercise.
  4. Lower the leg back to start position and then repeat the movement on the opposite side.

 

Lower Abdominal Series #2B

  1. In supine position with knees bent, feet on the floor, and a blood pressure cuff (or a hand) placed opposite the navel in the small of the back, lift the legs until the thighs are perpendicular to the body with the hips at 90 and the knees at 90. Note: the angle at the knee can be decreased to make the exercise easier if necessary.
  2. Pump the blood pressure cuff up to 40mmHg.
  3. Gently draw the navel in and then flatten the lower back into the cuff (or the hand) by posteriorly rotating the pelvis using the lower abdominals to raise the pressure on the cuff to 70mmHg.      
  4. Lower one leg back to the floor as you maintain the pressure on the cuff at 70mmHg, allowing the reading to vary no more than +/-5mmHg throughout the exercise.
  5. Raise the leg back up and perform the same movement on the opposite side.
  6. Repeat for the designated number of reps.

 

NOTE: All of the Lower Abdominal Series are best performed with a blood-pressure cuff placed opposite the navel and inflated to 40 mmHg (or 30 mmHg if lumbar curvature is deficient).  The athlete would then increase the reading on the dial 30 mmHg by posteriorly rotating the pelvis to increase the pressure.  For Lower Abdominal #2A and #2B, the leg movements should be performed with no more than 5 mmHg fluctuations above or below starting pressure (i.e., 60 or 70 mmHg). 

 

Forward Ball Roll

  1. In prone position with forearms on a physio ball, elbows at 90 and positioned underneath the shoulders, gently draw the navel in toward the spine.
  2. Push the ball forward by extending the arms as far as you can without losing the neutral curvatures of the spine. Lumbar spine will work but should not be the focus of the effort. Exercise can be descended by performing the movement from the knees as necessary.
  3. Pause at the end R.O.M. before returning to start position and repeating for the designated number of reps.

 

Oblique Cable Twist

  1. Standing with Good Posture, feet wider than shoulder width, and with a cable machine on the non-dominant side of the body, rotate torso so that hands are in front of the chest, grasping a handle attached to the cable. Dominant hand should be on first and non-dominant hand should be on top.
  2. Rotating along the axis of the spine, twist torso toward the dominant side. Movement should be initiated by the core, and the only reason the hands should move is because the chest moves first. Slowly return to start position by reversing the motion. Concentrate on a powerful positive and a controlled negative.
  3. Repeat for the designated number of reps before performing the movement with the opposite set up position in the opposite direction.

 

Oblique Raise

  1. Lying on the side of the body with the forearm perpendicular to the torso and the elbow directly underneath the shoulder, lift the hips off the floor until the body is one straight line from ankles to ears.
  2. Hold for the designated time period or do reps as prescribed. Note: exercise can be descended by bending the underneath leg which shortens the lever arm as the body is supported between the elbow and the knee.

 

Oblique Raise External Shoulder Rotation

  1. Lying on the side of the body with the dominant forearm perpendicular to the torso and the elbow directly underneath the shoulder, lift the hips off the floor until the body is one straight line from ankles to ears. The elbow of the non-dominant arm should be glued to the superior side of the body with the hand across the abdomen, grasping a very light dumbbell.      
  2. Hold this elevated position and externally rotate the non-dominant arm up as far as strength and flexibility will allow. Try not to let elbow deviate far from the body. Note: exercise can be descended by bending the underneath leg which shortens the lever arm as the body is supported between the elbow and the knee.
  3. Very slowly return the non-dominant arm to the start position and repeat for the designated number of reps while maintaining the elevated position.
  4. Perform the movement on the opposite side.

 

Oblique Raise Abductor

  1. Lying on the side of the body with the dominant forearm perpendicular to the torso and the elbow directly underneath the shoulder, bend the dominant leg at the knee so that the lower leg is perpendicular behind the body.
  2. Lift the hips off the floor while simultaneously abducting the non-dominant toward the ceiling as far as strength and flexibility allow.      
  3. Hold this elevated position and externally rotate the non-dominant arm up as far as strength and flexibility will allow.
  4. Pause end R.O.M. before slowly returning to the start position and repeating for the designated number of reps.
  5. Perform the movement on the opposite side.

 

Supine Lateral Ball Roll

  1. Seated on a physio ball, roll body down until the ball supports the head and shoulders. Feet are on the ground with the shins perpendicular to the floor. Arms should be out at the sides of the body like a tightrope walker or. A dowel rod can be placed across the chest and in both hands for cueing (it should remain level and in contact with the chest at all times.       Additionally, the thumbs should never be activated to hold onto the dowel rod). Maintain TVA function (i.e., navel drawn in slightly) to avoid over-recruitment of the lumbar erectors. Note: if lateral movement is sufficient to bring head off the ball, tongue should be placed on the roof of the mouth in the physiological rest position.
  2. Shuffle over to the non-dominant side while maintaining the hips in an elevated position and the rest of the body in perfect alignment. Pause at end R.O.M.
  3. Return to center and then shuffle over to the dominant side before pausing again.
  4. Move back to the center position and repeat for the designated number of reps.

 

Stabilizer Series

  1. In prone position with forearms on the floor, elbows at 90 directly underneath the shoulders, activate core musculature to maintain neutral spinal curvatures supported between the toes and forearms. This position can be held for time or progressing to the following steps if proficiency allows. If it’s difficult just to maintain the above position, descending the exercise can be accomplished by moving from the toes to the knees.
  2. Take dominant arm off the ground (and if strength will allow, the opposite leg, too) for the designated time.
  3. Return to start position and then repeat on the opposite side.

 

Bosu Prone Leg Lift

  1. In prone position with arms outstretched and hands placed shoulder width apart on a Bosu, lift one foot off the ground by extending at the hip (not the knee). Keep core activated so that lateral deviation of the Bosu/body is kept to a minimum.
  2. Return to start position and repeat the movement on the opposite side, alternating for the designated number of reps.

 

Push Up Row

  1. In prone position with arms outstretched and hands placed shoulder width apart and holding two dumbbells (the movement can be performed without the dumbbells, using just the hands if necessary), lower the body toward the floor until the upper arm is approximately parallel with the floor.
  2. Return to start position by extending the arms.
  3. Lift one dumbbell off the ground and pull it to the chest so that it just touches the rib cage. Keep core activated so that lateral deviation of the body is kept to a minimum. If necessary, move legs wider to give a more stable base of support.
  4. Return to start position and perform the movement on the opposite side before repeating the push up followed by the two rows again for the designated number of reps.

 

Prone Low Crawler             

  1. In prone position with forearms on the two physio balls of equal size, elbows at 90 directly underneath the shoulders, activate core musculature to maintain neutral spinal curvatures supported between the toes and forearms.
  2. Push the ball in contact with the non-dominant arm forward by extending the non-dominant arm.
  3. Return the arm to the original position and repeat the movement with the dominant side.
  4. Bring the dominant side back to the starting position and then repeat for the designated number of reps.

Squat Pattern Posted on October 30, 2013, 0 Comments

SQUAT

 

You don’t know squat. But you should. One of the seven primal patterns, squatting was essential for survival when we were cavemen and -women. And while evolution has developed our Texting pattern such that many of us have a thenar eminence the size of our bicep, our squatting skills have suffered in kind. Because of this, over 80% of people will endure an episode of back pain in his or her lifetime. And triathletes aren’t immune. So squat! It’s good for your back. It’s good for your knees. And it’s good for your triathlon performance. The only thing it’s not good for is your orthopedic surgeon’s bank account.

 

First Descent—1 dowel-rod support                         

Second Descent—2 dowel-rod supports                   

Third Descent—Swiss Ball on wall as support          

                                   

EXAMPLE EXERCISES

 

Back Squat

  1. Stand with a barbell on shoulders (not the neck) and with chest out, shoulders back, and navel in (this is Good Posture and gospel for every exercise as it emphasizes proper body positioning and activation of the TVA). Hands should be as close in on the bar as flexibility will allow. Feet should be positioned a little wider than hip width apart and either straight ahead or slightly externally rotated.
  2. Inhale to charge the thoracic cavity and then descend into a squat position by leading with the glutes as if sitting in a chair.       Go down as far as possible without pain or losing the lordotic curve in the lumbar spine.
  3. Return to the start position by pushing through the heels and exhaling through pursed lips after passing the sticking point of the ascent. Ensure knees track over feet throughout the movement.

 

Front Squat

  1. Stand with arms crossed, elbows facing forward, barbell on the shoulders and the thumbs of the hands, and with Good Posture. Feet should be positioned a little wider than hip width apart and either straight ahead or slightly externally rotated.
  2. Inhale to charge the thoracic cavity and then descend into a squat position by leading with the glutes as if sitting in a chair. Go down as far as possible without pain or losing the lordotic curve in the lumbar spine.
  3. Return to the start position by pushing through the heels and exhaling through pursed lips after passing the sticking point of the ascent. Ensure knees track over feet throughout the movement.

 

Step Up         

  1. Stand with Good Posture with non-dominant leg placed on a box/bench of appropriate height.
  2. Step onto the box/bench by pushing through the heel (think about pushing the box/bench away). Knee should track over the foot and torso should remain upright throughout the movement. Additionally, hips should not swing out to the side but should remain directly above the foot and knee.
  3. Return to the start position by descending under control, maintaining pressure through the heel so that glutes and hamstrings remain activated.

 

Crossover Step Up

  1. Stand with Good Posture behind and to the side of a box/bench of appropriate height.
  2. Beginning with the non-dominant side, bring the outside leg across the body and onto the outer edge of the box/bench.
  3. Step onto the box/bench by pushing through the heel (think about pushing the box/bench away). Knee should track over the foot and torso should remain upright throughout the movement. Additionally, hips should remain level throughout the movement.      
  4. Cross the non-dominant leg behind the body to descend back to the floor on the opposite side of the bench/box.
  5. Repeat in the opposite direction.

           

Unilateral Squat

  1. Stand with Good Posture on top of a box/bench.
  2. Take the dominant leg off the box/bench and bend the opposite knee to descend the body toward the floor.
  3. Maintain pressure through the heel of non-dominant leg, allowing knee to track over the foot and chest to remain elevated and hips to stay level throughout the movement. .
  4. Go as far as strength will allow with proper form and then push through heel to return to the start position.

 

High Step Up            

  1. Stand with Good Posture with non-dominant leg placed on a box/bench taller than knee height.
  2. Step onto the box/bench by pushing through the heel (think about pushing the box/bench away). Knee should track over the foot and torso should remain upright throughout the movement. Additionally, hips should not swing out to the side but should remain directly above the foot and knee.
  3. Return to the start position by descending under control, maintaining pressure through the heel so that glutes and hamstrings remain activated.

Neural Drive and the Triathlete Posted on October 28, 2013, 0 Comments

The more stable a joint is (from proper stabilizer/neutralizer development), the more force a prime mover working on that joint can produce. Asleep on machines, the nervous system is awakened when exercising in the proper environment. Yet when stabilizers and neutralizers are not activated—a direct effect of training exclusively on machines—the prime movers are inhibited.

To further illuminate the point I’m trying to make, let’s use a hypothetical example of a guy named Joe Pec Dec. Now, Joe spends so much time in the weight room that he probably gets his mail delivered there. In fact, the only time you don’t see this guy is when the local tanning salon is running a two-for-one special. Mr. Pec Dec (and hypothetical or not, he’s so much bigger than you and me, I suggest we refer to him as Mister Pec Dec) doesn’t care one iota about stabilizers or neutralizers, and that’s one of the reasons he trains on machines. Let’s face it: His goal is to get freaking HUGE. A body-building competition doesn’t give out awards for function. The requirements to grease the body down, step on stage, and flex individual body parts are elementary compared to the complex movements of swimming, cycling, and running in a triathlon. There is no need to:

 

Condition stabilizers and neutralizers in relation to the prime movers

Maintain their center of gravity over their own base of support

Integrate upper and lower extremity function

Train dynamic stability as well as static stability

Switch between righting reactions and tilting or equilibrium reactions

Be proficient at both closed and open-chain movements (see Chapter Five of Section Two)

Develop high levels of inter as opposed to intra-muscular coordination

 

It’s analogous to learning to drive a car. When you were fifteen or sixteen, despite your transparent attempts to look like you were born with a driver’s license, you had to really concentrate when behind the wheel. The distractions of light traffic, a person riding shotgun, or even a loud radio were detrimental to your mastery of driving (and hazardous to any mailboxes or trashcans that may have been positioned too close to the curb as well). You only had a certain amount of neural drive which you could allot to the task of driving.

But now you can sing to your favorite CD, put on make-up, talk on your cell, write down important messages, and eat a bowl of cereal—all while driving to work in rush-hour traffic. You’ve become, arguably, a better driver. You’ve reached the stage of autonomic development. You’ve got more neural drive to devote to the task of driving. Or, more specifically, being behind the wheel doesn’t require as much of your neural drive as it once did. The process of driving a car now doesn’t monopolize your concentration the way it did when you were a teenager. You’ve had years of driving in the real world, encouraging you to develop the skills necessary to function in that world. You’ve realized that if you want to go somewhere, you have to eventually take the car out on the road.

But bodybuilders aren’t going anywhere. Their competitive environment is the stage—a uniformly level environment whose only real threat is the occasional drop of baby oil that doesn’t get mopped up. Bodybuilders have the luxury of sitting down on a machine and concentrating solely on hammering out a set of eight to twelve with an obscene amount of weight. They can rely on the machine to:

           

Act as their stabilizers and neutralizers

Support their body

Isolate upper or lower extremity function

Nullify any need for dynamic or even static stability

Minimize the demand of righting reactions with no need for tilting reactions

Work primarily in an open-chain environment (sometimes a closed-chain one as well, but never both closed- and open-chain at the same time)

Train isolated movements requiring little to no intra-muscular coordination.

 

With no need to think about anything other than flexing a specific muscle, bodybuilders can focus all their neural drive on making that muscle work. This allows them to lift more and more weight and, with the right combination of rest and other ingredients, get bigger.

Triathletes—and this probably goes without saying—are different. Most of us don’t really care about bulging biceps or shredded pecs. We want to be fast, not big (the ripped quads are just a bonus). So if you want to be successful at this sport, it’s time you got off that machine and went somewhere. And if you want to go farther than your driveway, working on correct stabilizer/neutralizer development is not only a good idea—it’s essential.

Weak or untrained stabilizers can be overloaded quickly, sending inhibitory signals to the prime movers of a specific movement and resulting in decreased neural drive to those muscles. In other words, your nervous system will not allow the prime movers to fire at 100% of their capability when they are not protected by the stabilization provided by the machine. There is only one way to get around this problem and still follow the same machine-based gym protocol you’ve been doing for years. But I guarantee you that you’ll be a heck of a lot slower coming out of T1 with your gym’s leg press attached to your back.

Your body is smart. It realizes when the structural integrity of the joint over which that muscle crosses is compromised, even if you don’t. So you may be able to perform a squat on the Smith Machine with two hundred pounds. But your brain, just like when you were first learning to drive, won’t allow you to utilize that power on the bike when your legs aren’t guided through the motion like the thousands of reps you’ve performed in the past. There are just too many other things going on with which your machine-trained body is not familiar—like gravity, balance, and unguided motion. You simply will not be as strong on the bike as you thought. Strength training’s detractors will cite this as evidence that lifting weights is of no benefit to the endurance athlete. And if you continue to lift incorrectly, the only thing you really end up strengthening is their argument.

Go prove it to yourself. After a couple of warm-up sets, do eight reps of a bench press at a weight which makes the last repetition a challenge. Have your training partner spot you to ensure we don’t find your decaying carcass trapped underneath the bar a few days later. When finished, admire yourself in the mirror as you recover and stay loose for your next effort. Now, lie across a physio ball and perform a set of dumbbell chest presses with the same amount of weight.

I doubt you could complete another set of eight. You may not have even been able to get the weight up off your chest. Don’t feel bad. You just received a valuable lesson in neural drive which should feed your desire to train correctly. And if not, you can always get back on one of those machines and feed your ego!

Disproportionate development of prime movers in relation to stabilizers and neutralizers also changes the mechanics of joints. In the human body there are three classifications of joints or articulations: synovial, fibrous, and cartilaginous. These three can be further broken down into twelve subtypes, all of which share one common characteristic: They all are the points of contact between different bones. So if you change how a joint functions through an imbalanced exercise program (which is exactly the kind of program machine training lends itself to due to the inherent lack of stabilizer/neutralizer development), the result is the accelerated degradation of all the involved joint surfaces. Eventually you have bone contacting bone in places they were never meant to meet. The resulting liaison, despite all the anti-inflammatories in the world, can only end painfully.

In addition to the likely arthritic changes in a joint, overdevelopment of the prime movers in the absence of sufficient training for the stabilizers and neutralizers of the body creates a faulty motor program. Your body is like a computer. It stores the information on how to perform a given movement in what Richard Schmidt and Craig Wrisberg, in their book Motor Learning and Performance, term a generalized motor program. Yet each repetition of a movement performed on a machine essentially programs the computer with the wrong information. So stand up! Get off those machines. Turn your entire body on and program it with what it’ll need to survive your next competition.

How Can I Train My Abs Without Doing Crunches? Posted on October 07, 2013, 0 Comments

Squat

Dead Lift

Lunge

Step Up

Clean

Snatch

Turkish Get Up

Shoulder Press

Push Up

Pull Up

Row

Abdominal Hollowing

Lower Abdominal #1-#4

Plank

Side Bridge

Upper/Lower Body Russian Twist

Supine Lateral Ball Roll

Supine Hip Extension

Supine Hip Extension Knee Flexion

Swim, Bike, or Run

Good Ole Belly Laugh

Daily Bowel Movement

Simply Stand Up

Breathe Properly

Etc.

A Tool to Convert Strength to Power Posted on August 26, 2013, 0 Comments

 

Plyometrics are movements that teach the body to recruit the maximal amount of force in the shortest amount of time.  Sounds like the definition of power, right?  Used appropriately, plyometric training is the key to transferring the strength build in the weight room to speed in the competitive environment.  They will help move the force-velocity curve up and to the right.  Properly implemented into your training program, plyometrics will make you faster.

Try this experiment.  Stand next to a wall with your hands above your head and jump as high as you can.  Note how high you got.  Now move away from the wall before you do a second attempt.  This time, take a couple of steps toward the wall and then quickly drop into a partial squat before exploding up off the ground.  You jumped higher this time, didn't you?  What you just experienced is a live demonstration of the Stretch-Shortening Cycle--the underlying principle of plyometric training.

One of the mechanisms by which the body conserves energy to move more efficiently, the stretch-shortening cycle is an active stretching of a muscle under load (eccentric contraction) followed by an immediate shortening of the muscle (concentric contraction).  The time between the start of the eccentric movement and the concentric movement is called the amortization phase.  During this period, elastic energy is stored in the muscle tendon unit.  If the transition between eccentric loading and concentric movement takes too long, this elastic energy is dissipated as heat.  However, if this transition occurs rapidly enough, the stored energy is utilized to make the subsequent movement not only more efficient but more powerful as well.

The last time you had a physical, you probably had the doctor tap your patella tendon with a small rubber hammer.  And if he hit the right spot the right way, you had an involuntary contraction which would've made him a soprano if he had been standing in front of you without wearing a cup.  You had no control over your leg, so you'd get to take no credit for his new singing career.  That was the stretch reflex, or myotatic reflex, in action.  And that's the basis of plyometrics.

Don't Be Hamstrung! Posted on July 24, 2013, 0 Comments

Did you pull a hammie?  Be careful.  The recurrence rate in the first two months is approximately 22%.  But you can improve those odds by combining some knowledge of anatomy with your passion for training.

See, the hamstrings act on both the hip and knee, extending the former and flexing the latter.  During sprinting and other explosive movements, the hamstrings are typically lengthening while under tension.  This is what's termed an eccentric contraction.  And, unfortunately, concentric contractions (which predominate in most strength training programs) don't easily transfer to eccentric strength.  While there are many movements which can effectively train the hamstrings in the manner in which they're challenged, a simple one which can be implemented with no equipment is called the Nordic Hamstring Exercise.

With feet anchored (or using a partner as in the above illustration), pivot forward from the knees while maintaining core activation.  You should aim for one straight line from ears to knees, concentrating on not "breaking" at the waist.  Move only as far as you can (and it probably won't be far at first) with a goal of reaching the point where you almost get stuck and can't pull back.  The image of the figure in the middle above is likely as far as most people will go with good form.  Some people like to drop to the floor and then explosively push back up with the arms to the start position.  But the difficulty, along with the excessive loading and development of the internal shoulder rotators, makes this aspect of the exercise contraindicated in most cases.  

Studies show up to a 60% reduction in new hamstring injuries and up to an 85% reduction in recurrence compared to controls when incorporating this movement into a training program.  But go easy at first.  Otherwise, soreness will leave you walking funny for several days.  But at least you're walking.  And that's what you have to do before you run.  And you can't do that well unless you're hamstrings are strong and smart.  So train them to be that way. 


Posture and Swim Speed Posted on July 15, 2013, 0 Comments

There are two simple ways to swim faster:

increase your stroke rate (SR)

or

increase your stroke length (SL)

In other words, SR x SL = swimming velocity.  But Terry Laughlin, founder of Total Immersion, holds that increasing SR is self-limiting because energy cost goes up by a cubic relationship.  Taking your SR from two times per second up to four times per second results in you burning through your limited energy supplies eight times faster (2 x 2 x 2 = 8).  Laughlin goes on to state that “faster swimmers take fewer strokes than slower swimmers—at every level from Olympic finals to lap time at the local Y.”

But what if your pelvis is tilted anteriorly (a condition exacerbated by the tight lats which result from lots of pool time)?  What if your upper back assumes a position of kyphosis eerily similar to your seated workplace environment?  Then the short, tight muscles of the pectorals and deltoids will inhibit your reach, thus decreasing stroke length.  The only way to make up for this deficit is to increase your turnover, which costs you energy you cannot spare. 

In addition, the forward head carriage associated with a kyphotic posture puts your melon deeper in the water and greatly increases drag.  Ask the best swim coaches in the world and they’ll tell you that reducing drag will produce greater dividends in the water than anything else you can do.  You want to swim through the smallest cylinder possible.  But that’s hard to do when your cranium is virtually scraping the lane line at the bottom of the pool while your upper back breaks the surface of the water like the dorsal fin of a shark.  

 

That’s some serious drag you’re creating.  And it’s all because of your faulty posture.  Even worse, if you cannot extend the thoracic spine because you’re stuck in a position of kyphosis, every stroke you take will put excessive strain on the muscles and connective tissue of the shoulders.  As the prime movers involved in swimming become fatigued and their movements become less efficient, the four tiny muscles of the rotator cuff become overworked in an attempt to dynamically stabilize the glenohumeral joint.  Ten thousand meters a week later, and you’ve developed a nice case of swimmer’s shoulder. 

When defined as “significant shoulder pain that interferes with training or progress in training,” 35% of elite and senior level swimmers report episodes of swimmer’s shoulder.  What they are experiencing may not technically be swimmer’s shoulder but a similar condition called thoracic outlet syndrome.  The thoracic outlet is the space between clavicle and rib cage through which nerves and vascular structures pass from the neck and thorax to the arm.  The symptoms of thoracic outlet syndrome are similar to swimmer’s shoulder and numerous other clinical diagnoses, but they all have one thing in common.  As Kendall states,  “treatment should emphasize increasing the space of the thoracic outlet by improving the posture [and] correcting the muscle imbalance… that adversely affect the posture of the head, neck, and upper back.” (Italics mine.)

STRETCH: Sub Occipitals, Levator Scapulae, Pectorals, Anterior Deltoid, Latissimus Dorsi, All Hip Flexors 

STRENGTHEN: Deep Cervical Flexors, All Scapular Adductors, Lower Abdominals, Glutes

Other actions would likely need to be taken, too.  But the above prescription is a good place to start.  And just like posture, if you begin in the right place, you have a greater chance of ending in the right place.  

Machine Training Faults: Stabilizers Posted on July 07, 2013, 0 Comments

Weak or untrained stabilizers can be overloaded quickly, sending inhibitory signals to the prime movers of a specific movement and resulting in decreased neural drive to those muscles.  In other words, your nervous system will not allow the prime movers to fire at 100% of their capability when they are not protected by the stabilization provided by the machine.  

See, your body is smart.  It realizes when the structural integrity of the joint over which that muscle crosses is compromised, even if you don’t.  So you may be able to perform a squat on the Smith Machine with two hundred pounds.  But your brain, just like when you were first learning to drive, won’t allow you to utilize that power when your legs aren’t guided through the motion like the thousands of reps you’ve performed in the past.  There are just too many other things going on with which your machine-trained body is not familiar—like gravity, balance, and unguided motion.  You simply will not be as strong as you thought.  Strength training’s detractors will cite this as evidence that lifting weights is of no benefit to sports performance.  And if you continue to lift incorrectly, the only thing you really end up strengthening is their argument.

Go prove it to yourself.  After a couple of warm-up sets, do eight reps of a bench press at a weight which makes the last repetition a challenge.  Have your training partner spot you to ensure we don’t find your decaying carcass trapped underneath the bar a few days later.  When finished, admire yourself in the mirror as you recover and stay loose for your next effort.  Now, lie across a physio ball like the subject below (though, personally, I'd advise having the head supported by the ball, too--otherwise you'll overdevelop the SCM's and perpetuate forward head posture) and perform a set of dumbbell chest presses with the same amount of weight. 

 

I doubt you could complete another set of eight.  You may not have even been able to get the weight up off your chest.  Don’t feel bad.  You just received a valuable lesson in neural drive which should feed your desire to train correctly.  And if not, you can always get back on one of those machines and feed your ego!